Using Encounter Decision Aids to Share Decisions With Women Presenting With Heavy Menstrual Bleeding or Fibroids [20H]


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Abstract

INTRODUCTION:Heavy menstrual bleeding impacts women’s quality of life and can be treated in a variety of ways. Shared decision-making (SDM) requires providing tailored information to the patient about options and eliciting and integrating patient preferences as treatments are selected. decision aids used during the clinical encounter may facilitate SDM. We evaluated the impact of introducing decision aids for women presenting with heavy menstrual bleeding or fibroids on the level of SDM.METHODS:A before-after study was conducted in general OB-GYN practice in an academic medical center and two community practices between December 2014 and May 2015. Consultations were compared before (T1) and after (T2) introduction of two encounter decision aids on treatment options for heavy menstrual bleeding or uterine fibroids. Immediately after their appointments, patients filled out a brief validated survey (CollaboRATE) about the perceived level of SDM. Additionally, observers rated audio recordings of consultations for SDM using the OPTION5 instrument.RESULTS:Altogether, 16 providers participated, 25 patients were enrolled in T1, and 28 patients were enrolled in T2. The groups did not differ on demographic characteristics. The proportion of women reporting SDM increased significantly from T1 (50%) to T2 (75%; p < 0.05). The mean observer-rated level of SDM also increased significantly from T1 to T2 (mean difference = 12.50 on a scale of 0-100, where threshold for clinical relevance is 11.9).CONCLUSION:Implementation of encounter decision aids for women presenting with heavy menstrual bleeding or fibroids was associated with a higher level of SDM between women and gynecologists.

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