Patient-identified needs for hormone replacement therapy counseling: A qualitative study

Background: Numerous medical organizations, including the American College of Physicians, have recommended that women be counseled about postmenopausal hormone replacement therapy (HRT). Patients' perspectives on their counseling needs, however, have not been integrated into most counseling guides. Objective: To use patient self-reports to identify needs for HRT counseling. Design: Individual, in-depth patient interviews. Setting: Managed care organization. Patients: 26 women who had received an initial prescription for HRT. Measurements: Qualitative, consensus review of the content of interview transcripts. Results: On average, women reported 15 factors (range, 6 to 24 factors) as critical to their decision-making process. Although most women cited their physician's opinion (96%), reports in the media (81%), and experiences and opinions of friends (77%) as critical to their decisions about HRT, counseling recommendations address none of these concerns. Conclusions: Many women in a managed care organization who accepted a prescription for HRT identified counseling needs that are not included in widely used HRT guidelines.