Increasing Perimenopausal Patient and Clinician Satisfaction with Care Through Use of Shared Decision Making

Vasomotor symptoms (VMS) associated with menopause vary greatly, as do the multitude of available treatment options. It can be difficult for clinicians to manage these symptoms while balancing patient safety concerns and preferences. Shared decision-making (SDM) can assist both the provider and patient to navigate the various treatment options, minimizing gaps between their preferences.

To assess the effect of SDM in a nurse-led practice in the Southwest, two nurse practitioners (NP) were invited to use a menopausal decision aid (DA). Women aged 40 to 64 years experiencing VMS were invited to participate in the project. Following a visit with the NP in which the DA was used, patients completed a six question post-intervention survey based on both the Decisional Conflict Scale (DCS) and SDM-Q-9 surveys. Patients were also asked to complete a telephone interview about the process 1-2 weeks post-intervention. The NP completed a post-intervention survey based on the SDM-Q-Doc to assess clinician satisfaction with the SDM process. Eight patients (mean age, 47.9 years), presenting with a range of 2 to 6 perimenopausal symptoms participated in the project.

All patients (100%) strongly or completely agreed that the clinician precisely explained the advantages & disadvantages of treatment options, helped them understand all the information, reached an agreement on how to proceed with care, and were extremely satisfied or satisfied with their decision and making an informed choice. Both clinicians completely agreed they had come to an agreement on how to proceed, and completely or strongly agreed they helped the patient understand all information. There was a correlation between the use of SDM patient’s age, making an informed choice, and being satisfied with their decision. Incorporating a perimenopausal DA can enhance patient and clinician satisfaction with SDM to understand their treatment options and make an informed menopausal decision.