An Ah Reum, Shin Dong Wook, Chun So Hyun, Lee Hyun-Ki, Ko Young-Jin, Lee Hyejin, Son Ki Young, Choi Ho-Chun, Cho Belong, Lee Jong-koo, Kim Jung Gu
From the 1Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea; 2Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea; 3Department of Family Medicine, Korea Cancer Center Hospital, Seoul, Republic of Korea; 4Department of Policy and Development, Seoul National University Hospital, Seoul, Republic of Korea; 5JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; and 6Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Republic of Korea.
Menopause. 2014 Jul;21(7):726-31. doi: 10.1097/GME.0000000000000170.
This study aims to assess the current status of shared decision-making on instituting postmenopausal hormone therapy (HT).
Two cross-sectional nationwide surveys of postmenopausal women and primary care physicians in the Republic of Korea were conducted in 2012 via face-to-face interviews. A total of 685 women (aged 50-69 y) who with natural menopause and 250 primary care physicians were included.
Only 56.8% of primary care physicians reported that they explain the benefits and risks of HT and leave the decision to postmenopausal women. The others usually recommended using or not using HT. Of those postmenopausal women who had discussed such therapy with physicians (147 of 685; 21.5%), not all were aware of breast cancer or cardiovascular risks (only 65.3% and 38.8% were informed, respectively). Although most physicians perceived HT as beneficial for menopausal symptom control (99.6%) and acknowledged the related risk of breast cancer (84.8%), nearly half had the impression that HT was preventive of cardiovascular diseases. The interviewed women were less informed of the benefits and risks of HT than were the physician respondents. The awareness levels of the treated and untreated women did not differ.
Participation of postmenopausal women in deciding whether to use HT is not prevalent. Physician-woman information transfer is suboptimal, and treatment decisions often are not based on the best available evidence. The current status of shared decision-making in this setting is clearly in need of improvement.
本研究旨在评估绝经后激素治疗（HT）共同决策的现状。
2012年，通过面对面访谈对韩国绝经后女性和初级保健医生进行了两项全国性横断面调查。共纳入685名自然绝经的女性（年龄50 - 69岁）和250名初级保健医生。
只有56.8%的初级保健医生报告称，他们会解释HT的益处和风险，并将决策留给绝经后女性。其他人通常会推荐使用或不使用HT。在那些与医生讨论过此类治疗的绝经后女性中（685名中的147名；21.5%），并非所有人都了解乳腺癌或心血管疾病风险（分别只有65.3%和38.8%被告知）。尽管大多数医生认为HT对控制更年期症状有益（99.6%），并承认存在相关的乳腺癌风险（84.8%），但近一半的医生认为HT可预防心血管疾病。接受访谈的女性对HT益处和风险的了解程度低于医生受访者。接受治疗和未接受治疗的女性的知晓水平没有差异。
绝经后女性参与决定是否使用HT的情况并不普遍。医生与女性之间的信息传递不理想，治疗决策往往并非基于现有最佳证据。这种情况下共同决策的现状显然需要改善。
