నైరూప్య

A patient education intervention program to increase menopause knowledge and improve shared decision making in women

Stuti Dang

 Background: In North America, there are approximately 30 million women in the menopausal age range of 40-54 years. Since menopause can be a time of changes, women may be interested in receiving information regarding menopause and management of associated symptoms such as hot flashes, mood instability and vaginal dryness. Although there are ways to alleviate these symptoms, many women, due to their limited knowledge related to menopause, are not aware of these treatment options nor able to determine which options would be best for them. Many healthcare providers fail to identify women who may present with menopausal symptoms, thus failing to offer them treatments to alleviate these symptoms. Methods: We developed at the Miami VA healthcare system, a project called the “My HealtheVet to Enable And Negotiate for Shared decision making” or MEANS project, an unblinded non-randomized pilot project, to deliver an educational intervention program surrounding the management of menopause. The project identified female veterans of perimenopausal and menopausal age (45 to 60 years) at three VA Health Systems (VAHS) – Miami, Orlando, and West Palm Beach. The six-month intervention provided educational resources on menopause and shared decision making (SDM) through the MyHealtheVet electronic portal system to women in the Miami VAHS only. Following the intervention, data regarding patient knowledge and use of the MyHealtheVet portal was collected. The project compared the impact of the MEANS intervention on patients at the Miami VAHS to women veterans of the same age who did not receive this intervention across the three VAHS sites. Results: At the initiation and conclusion of the study, participants completed a test assessing their knowledge of menopause. This test was scored out of 18 points, with a higher score indicating a higher level of knowledge. At the beginning of the intervention, the average score was 14.7 with a standard deviation of 2.4. Following the intervention, the average score increased to 15.8 with a standard deviation of 1.8. Along with knowledge tests, women were asked to rate their perceived understanding of menopausal symptoms and the associated treatment options. Women rated their knowledge to be higher following the intervention, suggesting that the MEANS project increased participants’ confidence in their understanding of menopause. In addition, the MEANS project increased understanding of Shared Decision Making (SDM), and increased use of the MyHealtheVet portal among participants. Conclusions: These findings are promising and suggest that an educational intervention could be effective in increasing women veterans’ access to treatment for the symptoms of menopause.