Factors affecting shared decision‐making concerning menopausal hormone therapy

Author:

Koysombat Kanyada12,Mukherjee Annice3,Nyunt Sandhi12,Pedder Hugo4,Vinogradova Yana5,Burgin Jo6,Dave Harshida7,Comninos Alexander N.12,Talaulikar Vikram8,Bailey Julia V.9,Dhillo Waljit S.12,Abbara Ali12

Affiliation:

1. Section of Endocrinology and Investigative Medicine, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine Imperial College London London UK

2. Department of Endocrinology Imperial College Healthcare NHS Trust London UK

3. Spire Manchester Hospital Manchester UK

4. Department of Population Health Sciences University of Bristol Bristol UK

5. Division of Primary Care, School of Medicine University of Nottingham Nottingham UK

6. Centre for Academic Primary Care Bristol Medical School Bristol UK

7. Woman representative with lived‐experience of menopause London UK

8. Reproductive Medicine Unit University College Hospital London UK

9. eHealth Unit, Department of Primary Care and Population Health University College London Royal Free Hospital London UK

Abstract

AbstractMenopausal hormone therapy (MHT) is an effective treatment for menopause‐related symptoms. Menopause management guidelines recommend a personalized approach to menopause care, including MHT use. Decision‐making around menopause care is a complex, iterative process influenced by multiple factors framed by perspectives from both women and healthcare providers (HCPs). This narrative review aims to summarize evidence around factors affecting decision‐making regarding menopause‐related care. For HCPs, the provision of individualized risk estimates is challenging in practice given the number of potential benefits and risks to consider, and the complexity of the data available, especially within time‐limited consultations. Women seeking menopause care have the difficult task of making sense of the benefit versus risk profiles to make choices in line with their decisional needs influenced by sociocultural/economic, educational, demographic, and personal characteristics. The press, social media, and influential celebrities also impact the perception of menopause and decision‐making around it. Understanding these factors can lead to improved participation in shared decision‐making, satisfaction with the decision and decision‐making process, adherence to treatment, reduced decisional regret, efficient use of resources, and ultimately long‐term satisfaction with care.

Funder

National Institute for Health and Care Research

Publisher

Wiley

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