Patient knowledge about hormone replacement therapy: Implications for treatment

Objective: To determine whether women's global self-assessment of their kno wledge about hormone replacement therapy (HRT) corresponds to their perform ance on an explicit knowledge test about HRT and to measure associations am ong knowledge, personal characteristics, decision conflict, and intention t o use HRT. Design: Preintervention telephone survey of 156 women enrolled in a randomi zed, placebo-controlled trial of HRT decision aids. Results: The mean rating of menopause knowledge, on a scale from 1 to 10, w ith 10 indicating being "extremely knowledgeable," was 5.6 (range = 0-10) a nd of HRT was 4.2 (range = 0-9). The mean summary score for the explicit HR T knowledge test, on a 16-point scale, was 7.8 (range = 0-15). After adjust ment for demographic characteristics and exposure to a provider conversatio n, higher income, white race, and the provider discussion were significant correlates of knowledge. Explicit knowledge was positively correlated with self-assessed menopause k nowledge and HRT knowledge (Spearman's correlation coefficient = 0.39 and 0 .52, respectively; p < 0.0001). Greater knowledge was not associated with i ntention to use HRT 1 year later. Women who had greater knowledge reported less conflict about the HRT decision (Spearman's correlation coefficient = -0.32; p < 0.0001). Conclusions: A global question about level of knowledge is an effective cli nical tool for identifying patients who are in need of additional education about HRT and menopause in this managed care population. Increased knowled ge may decrease women's conflict about the HRT decision. Having had a previ ous conversation about menopause with a primary care provider is associated with greater knowledge about HRT. (Menopause 2000;7:266-272. (C) 2000, The North American Menopause Society.).