Women's responses to a mailed hormone replacement therapy workbook

Objective: Effectively communicating information about the complex decision s that face women at midlife, including whether to use hormone replacement therapy (HRT), is an ongoing challenge. Although numerous decision-making t ools exist, few have been evaluated. The objective of this study was to exa mine women's use of a workbook designed to promote informed HRT decision-ma king. Design: We developed a workbook to prepare women to discuss HRT, osteoporos is, heart disease, and breast cancer with their providers. To evaluate the workbook, women aged 45-65 years were randomly assigned to one of three gro ups: (1) workbook plus baseline and 6-month surveys, (2) workbook and 6-mon th survey, or (3) no workbook with both surveys. Results are based on the r esponses of 580 women in groups 1 and 2 (response rate, 84.2%). Results: At 6 months, 79% of women recalled receiving the workbook, of whom 51% read all or most of it, 35% skimmed or read part of it, and 14% did no t read it. The percentages of women completing self-assessments were 55% os teoporosis; 56% heart disease; 58% breast cancer; 57% advantages and disadv antages of HRT; and 52% personal preferences about HRT. As a result of the workbook, 10% made an appointment with their providers, and 12% had a discu ssion about HRT with their providers. Use of the workbook was not associate d with menopause symptoms, attitudes about or use of HRT, hysterectomy, or provider discussions about menopause and HRT. Conclusion: This simple approach of using a mailed workbook holds promise a s a successful mechanism to prepare women to discuss HRT and other related health issues with their providers.