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Patient Educ Couns. 2007 May;66(2):211-22. Epub 2007 Feb 20.

A tale of two studies: the importance of setting, subjects and context in two randomized, controlled trials of a web-based decision support for perimenopausal and postmenopausal health decisions.

Author information

  • 1Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Benedict Building, Worcester, MA 01655, USA. Barry.Saver@umassmed.edu

Abstract

OBJECTIVE:

Knowledge relevant to women's peri- and postmenopausal health decisions has been evolving rapidly. Web-based decision supports can be rapidly updated and have the potential to improve the quality of patients' decisions. We developed and tested a web-based decision support for peri- and postmenopausal health decisionmaking.

METHODS:

We recruited 409 women aged 45-75 for one randomized, controlled trial and 54 women with an upcoming clinic appointment for a subsequent trial. Women were randomized to use the web-based decision support versus a printed brochure (first trial) and usual care (second trial). Outcomes were changes in decisional satisfaction, decisional conflict, and knowledge, both within each trial and compared across the trials.

RESULTS:

Intervention subjects had greater increases in decisional satisfaction in the second trial and knowledge in both trials. A high dropout rate among women randomized to the website in the first trial effectively negated benefits in that trial, but not in the second.

CONCLUSIONS:

The utility of this web-based decision support in two trials depended on a number of factors that appear related to the urgency of making a decision.

PRACTICE IMPLICATIONS:

Decision aids should be targeted to patients actively trying to make a decision.

PMID:
17317080
[PubMed - indexed for MEDLINE]
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