Evaluation of a natural health product patient decision aid: A tool for middle aged women considering menopausal symptom relief

Abstract

Objective. To evaluate the effectiveness of a patient decision aid (PtDA) for menopausal women facing decisions about natural health products (NHPs). Background. Women experience difficulty making decisions about NHPs for the management of menopausal symptoms. Factors influencing the decision include lack of information, and inadequate communication, and support from health care providers. Decision support interventions that have been demonstrated to be successful in addressing women's decisional needs are decision aids. Although a new decision aid is available, its English version has not been evaluated in a community-based/clinical setting to determine its effect on decision quality or the process of decision making. Design. A pre-/post-test quasi-experimental study. Setting. The Women's Health Center at The Ottawa Hospital, Ottawa Canada. Participants. Peri- or post-menopausal women aged 45 to 64 considering the use of NHPs for management of menopausal symptoms. Intervention. Self-administered NHP PtDA. Main outcome measures. The primary outcome measure was the level of decisional conflict as measured by the Decisional Conflict Scale. Secondary outcomes included knowledge, strength of values, and choice/preference. Results. Of 24 women, the typical participant was 50 to 59 years of age, Caucasian, married, and well educated. Compared to baseline, after using the decision aid, women's total decisional conflict was reduced from 63% to 23% (p < 0.001) and knowledge improved from 76% to 87% (p = 0.001). The values clarification exercise revealed that women who preferred NHPs were more likely to rate the non-chemical aspect as important and the cost of the NHP as less important. Of the 24 women, 10 were unsure of their choice at baseline and 3 post use of the decision aid (p = 0.015). Overall, women rated the decision aid as acceptable, clear, and balanced. Conclusion. The NHP PtDA improved decision quality and supported menopausal women who were facing health decisions around using NHPs for menopausal symptoms.