A systematic review of menopausal symptom management decision aid trials.

OBJECTIVE To systematically review the literature regarding the effects of menopausal symptom management decision aids. METHODS Using pre-designated inclusion and exclusion criteria, relevant articles were located using the PubMed.gov online search engine and reviewing reference lists of relevant articles. Full-text, English-language, peer-reviewed articles relevant to testing decision aids in uncontrolled trials (UCT) and randomized controlled trials (RCT) were reviewed. RESULTS The 18 articles represented 15 trials focused on natural health products decision aids (1 UCT, 1 RCT) or hormone therapy decision aids (1 UCT, 12 RCT). Whereas the natural health products aid was intended for women deciding about menopausal symptom management strategies, decision aids for hormone therapy were intended for a broader group of menopausal women and included indications for symptom management, prevention of heart disease, and prevention of osteoporosis. Many trials occurred prior to two pivotal events: the 2002 announcement of the Women's Health Initiative findings and the 2006 publication of the International Patient Decision Aids Standards. Study limitations may help explain contradictory findings for outcomes such as decisional conflict, decisional confidence, decisional satisfaction, knowledge and values, and decisions. CONCLUSIONS There is a relatively scant contemporary literature related to menopausal symptom management decision aids. Additional methodologically sound studies are needed to develop and subsequently test decision aids that are based on (a) contemporary knowledge regarding the wide array of available therapies and (b) international standards for decision aids that include consideration of women's values and preferences.