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

Abstract

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 compared with written information alone. 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.

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