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Effectiveness of a Computerized Decision Aid in Primary Care on Decision Making and Quality of Life in Menorrhagia: Results of the MENTIP Randomized Controlled Trial

National Primary Care Research and Development Centre, University of Manchester, Manchester, United Kingdom, j.protheroe{at}manchester.ac.uk

Peter Bower, PhD

National Primary Care Research and Development Centre, University of Manchester, Manchester, United Kingdom

Carolyn Chew-Graham, MD

Rusholme Academic Unit, School of Community Based Medicine, University of Manchester, Manchester, United Kingdom

Tim J. Peters, PhD

Academic Unit of Primary Health Care, Department of Community Based Medicine, University of Bristol, Bristol, United Kingdom

Tom Fahey, MD

Division of Community Health Services, University of Dundee, Mackenzie Building, Dundee, United Kingdom

Background. Computerized decision aids have the potential to increase patient involvement in the decision-making process. However, most published evidence concerning the effectiveness of decision aids is from secondary care. Aim. To evaluate whether the addition of a computerized decision aid to written information improves decision making in women consulting their general practitioner with menorrhagia comparedwithwritten informationalone. Design of study. Randomized controlled trial. Setting. Nineteen general practices in the North of England. Method. One hundred forty-nine women presenting with menorrhagia were randomized to receive written information and access to a computerized decision aid or written information alone. Outcomes were assessed using postal questionnaires. These were scores on the Decisional Conflict Scale and State-Trait Anxiety Inventory anxiety scale at 2 weeks and the Menorrhagia Specific Utility quality-of-life scale, knowledge about menorrhagia, and anxiety and process measures at 6 months. Results. Two weeks after the intervention, there was significantly less decisional conflict in the intervention group (adjusted difference = –16.6; 95% confidence interval [CI] = –21.5 to –11.7; P < 0.001). At 6 months, the intervention group showed better knowledge about menorrhagia (adjusted difference = 9.3 ; 95% CI = 1.9 to 16.6; P = 0.014) and menorrhagia quality of life (adjusted difference = 10.9; 95% CI = 0.9 to 21.0; P = 0.033). There was no difference in anxiety scores at either 2 weeks or 6 months. Conclusions. A computerized decision aid, used outside of the primary care consultation, is effective in increasing patient involvement in decision making in primary care.

Key Words: Key words: decision aids • shared decision making • patient participation • menorrhagia. (Med Decis Making 2007;27:575—584)

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