To assess physicians’ perceptions of the importance of having well-informed patients and having explicit discussions of patients’ preferences in menopausal symptom management decisions and frequency that they report both in their practices.
Methods:
188 U.S. physicians who had seen patients with menopause symptoms within the past year were invited (identified through the American Medical Association Master file) and 108 (57%) agreed to participate. Respondents stated how important it is that a patient is well-informed and that her preference is explicitly discussed before a decision is made. Participants then self-assessed how well this happened in their practices. Perceptions of the importance of informed and shared decision making and reported practices were evaluated in aggregate and stratified by physicians’ characteristics (gender, specialist status, duration of practice, the number of menopausal patients and knowledge).
Results:
57 (53%) physicians were female. 55 (51%) physicians identified themselves as a specialist (obstetrician & gynecologist). Mean duration in practice was 19.7 years (SD = 9.1). Median number of patients with menopausal symptoms seen per year was 100 (interquartile range = 250; 50-300). Mean knowledge score was 80.3% (SD = 9.1). 64% of physicians reported that they used educational materials, such as a brochure or a decision aid, to help inform patients before treatment decisions are made.
92% of physicians felt that it is very or extremely important that their patients are well informed about treatments for menopause but only 48% of physicians reported that their patients are very or extremely well-informed about treatments for their menopause. 97% of physicians felt that it is very or extremely important to explicitly discuss patients’ preferences before a treatment decision is made, and 84% of physicians reported that they always explicitly discuss patients’ preference before a treatment decision is made.
Specialist physicians were more likely to feel that their patients are extremely well-informed compared to non-specialist physicians (16% versus 2%; p = 0.006). Female physicians were more likely to feel that it is extremely important to explicitly discuss patients’ preferences compared to male physicians (82% versus 63%; p = 0.022).
Conclusions:
There are significant gaps between the perceptions of the importance of informed and shared decision making and frequency of its occurrence in practices in menopausal symptom management.
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