Decision making in hormone replacement therapy

OBJECTIVE To compare the efficacy of a decision-making aid with an informat ion document from the Society of Obstetricians and Gynaecologists of Canada (SOGC) with regard to decisions about hormone replacement therapy (HRT). DESIGN Randomized clinical trial. SETTING Quebec city region. PARTICIPANTS Menopausal Francophone women 45 to 69 years old. INTERVENTIONS Subjects were given a manual and an audiocassette describing a six-step approach to making a decision about HRT. MAIN OUTCOME MEASURES Amount of anxiety over the decision (main outcome), g eneral knowledge of the risks and benefits of HRT, personal expectations an d values concerning these risks and benefits, and women's views on HRT. RESULTS Anxiety levels were significantly reduced in both groups, but the d ifference between the effectiveness of the two interventions was not signif icant (P = .77). Percentages of women whose general knowledge increased and of women with realistic expectations were significantly higher in the expe rimental group (P < .003 and P < .0001, respectively). Congruence between p ersonal values and decisions about HRT increased significantly more in the experimental group (P less than or equal to .003). CONCLUSION The six-step approach to decision making was more helpful than t he SOGC's information document in increasing subjects' knowledge of the ris ks and benefits of HRT, in creating more realistic expectations of HRT, and in increasing the congruence between subjects' personal values and their d ecisions on HRT.