In other words, they're curious about what they need to know in order to make informed decisions. Sadly, their queries are met only by the sounds of silence. According to a study published in the August 17th edition of the Annals of Internal Medicine, physician guidelines are woefully inadequate in helping physicians counsel women in their decision-making process about whether to take postmenopausal estrogen replacement therapy. Based on their findings, the study's authors say that future guidelines should instruct physicians to incorporate patients' perspectives into the counseling process. Currently, the American College of Physicians, American College of Obstetrics and Gynecology and the U.S. Preventive Services Task Force publish guidelines that recommend that caregivers counsel patients about the risks and benefits of therapy.
All recommendations incorporate the best epidemiological evidence for hormone replacement therapy.
However, they do not reflect the counseling needs expressed by patients. For this study, researchers at Harvard Medical School conducted indepth interviews of women who had received a prescription for hormone replacement therapy. The women identified 15 factors as critical to their decision-making. Greater information about what the patient is thinking may help clinicians structure the time they spend and the materials they provide to patients. It is our hope that future recommendations incorporate the patients' perspective.