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Menopausal hormone therapy decisions: insights from a multi-attribute model.

Schapira MM, Gilligan MA, McAuliffe TL, Nattinger AB. Menopausal hormone therapy decisions: insights from a multi-attribute model. Patient education and counseling. 2004 Jan 1; 52(1):89-95.

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A multi-attribute utility (MAU) decision model for menopausal hormone replacement therapy (HRT) was developed using structured interviews (n = 40) to identify decision factors, and a telephone survey (n = 97) to ascertain utility scores. Utility scores for individual factors and composite scores reflecting the HRT decision were compared according to HRT use. Composite utility scores (range of -1.0 to 1.0, with higher values supporting HRT use) were 0.55, -0.27, and -0.19 for the 48 HRT users, 23 former users, and 26 never users, respectively (P < 0.0001). Among HRT current users, the main factors supporting use were concerns about heart disease, osteoporosis, and symptoms of menopause. Among former users, side effects weighed heavily against use, and among never users breast cancer concerns weighed heavily against use. Linear regression methods were used to identify the utilities most predictive of current HRT use. The decision model provided insight regarding how personal expectations and values influence HRT use.

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