AAFP National Research Network

Practices Sought to Study Shared Decision-making in Managing Menopausal Symptoms

December 11, 2013 01:00 pm News Staff

The AAFP National Research Network (AAFP NRN) is recruiting practices to participate in a research project designed to evaluate a patient-centered, shared decision-making intervention that involves managing menopausal symptoms in women ages 45-65. The project is slated to include 12 primary care practices that use an electronic health record (EHR) system and have a wireless Internet connection patients can readily access.

[Stock photo of older Asian woman sitting on a couch using a tablet computer]

Study Context

About half of all women ages 45-60 experience at least one menopausal symptom, but only one-third of them say they have talked with their primary care clinician about management options, and 45 percent say information about treating menopausal symptoms is confusing.

Previous research has demonstrated that hormone therapy (HT) is the most effective treatment for such symptoms and is an acceptable management option for many women as old as 59. For women who cannot or do not want to use HT, however, other options may be considered. In addition, it's important to ensure that women ages 60-65 stop using HT -- unless it's deemed appropriate -- because of the added risks associated with long-term HT use.

Furthermore, it has been shown that women's breast cancer risk rises with age. Medications to mitigate the likelihood of developing primary breast cancer are recommended for those at increased risk, but their use remains low. Because the issues that affect women on either end of this age spectrum (i.e., older or younger than 60) vary and require different management options, it is important to offer appropriate and individualized treatment choices.

Design and Implementation

Each practice selected to participate in the AAFP NRN project will enroll about four patients -- selected from women in the practice who come in for a chronic care visit or annual exam -- per month for 10-12 months, for a total of 40 women. Participating practices will be issued two tablet computers for the women to use for all project-related activities. After giving informed consent, each of the women will provide basic demographic information, confirm their current menopausal drug therapy and complete a brief post-visit survey.

As the women cycle into the intervention phase of the project, they also will complete two health risk appraisals that focus on menopause symptoms and breast cancer risk. Tailored educational video vignettes will be provided to boost their knowledge about menopause. Participating health care professionals will be asked to complete a one-hour educational session before the intervention begins.

The primary aims of the project are to

  • evaluate the impact of improved information collection and documentation of diagnosis of menopausal or postmenopausal symptoms, and
  • assess patient and health care professional satisfaction with the shared decision-making process.

Addressing medication use and patient-clinician communication will be secondary aims of the project.

Practices that complete all activities during the yearlong project will receive $7,000 in compensation and will be able to keep the two tablet computers. In addition, AAFP members have the option of self-reporting as many as 22 CME credits for research participation.

The study is funded by grants from Pfizer Pharmaceuticals.

Practices interested in participating are invited to apply online(www.surveymonkey.com). Questions may be directed to AAFP NRN Research Project Manager Robin Liston, M.P.H., via email to rliston@aafp.org or by phone at (800) 274-2237, Ext. 3175.