• Open Access

What factors are associated with a woman's decision to take hormone replacement therapy? Evaluated in the context of a decision aid

Authors

  • Heather D. Clark MD CM MSc,

    1. Department of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada,
    2. Clinical Epidemiology Unit, Ottawa Health Research Institute, Ottawa, Ontario, Canada and
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  • Annette M. O'Connor RN PhD,

    1. Department of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada,
    2. Clinical Epidemiology Unit, Ottawa Health Research Institute, Ottawa, Ontario, Canada and
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  • Ian D. Graham PhD,

    1. Department of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada,
    2. Clinical Epidemiology Unit, Ottawa Health Research Institute, Ottawa, Ontario, Canada and
    3. Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
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  • George A. Wells PhD

    1. Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Dr Heather Clark
Ottawa Hospital
Civic Campus
405-737 Parkdale Ave.
Ottawa
Ontario K1Y 4E9 Canada
E-mail: hclark@ohri.ca

Abstract

Objectives  To understand the factors associated with a post-menopausal woman deciding to take hormone replacement therapy (HRT) after reviewing a decision aid (DA) and having a counselling visit with her physician as well as the factors associated with the act of taking HRT 2 months after the counselling interview.

Design  A secondary analysis of data collected for a randomized controlled trial evaluating two DAs.

Main outcome results  Although 28% of women were uncertain regarding their decision after the counselling interview, only 2.4% of women, at the assessment at 2 months, had not made a decision. The most significant factor associated with the decision to take HRT, after the physician visit, was the physician preference (OR: 62, 95% CI: 13.3, 289.7). Physician preference (OR: 78, 95% CI: 6.2, 975) remained the most significant factor for taking HRT 2 months after the counselling interview followed by low uncertainty about the decision (OR: 0.4, 95% CI: 0.2, 0.7).

Conclusion  Physician preference was the factor that was most associated with the woman's decision following counselling and 2 months later. Qualitative evaluation of the interview process involving the patient and physician would determine whether the patient and physician are reaching a shared decision or is the physician preference influencing the patient.

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