Decision aids

Increasing patient participation in treatment decision is important in view of the wide choices available. Decision aids come in a variety of formats including leaflets, audiotapes, decision boards, computer programs, videos, websites, and structured interviews. These were examined in a randomized controlled trial with 2 years of follow-up of 894 women [19,38]. Women were randomized to the control group, information alone group (booklet and video), or information plus interview group (interview). Hysterectomy rates were lower for women in the interview group (38%) (adjusted odds ratio [OR], than in the control group (48%) and women who received the information alone (48%). The interview group had lower mean costs ($1566) than the control group ($2751) (mean difference, $1184; 95% CI, $684-$2110) and the information group $2026 (mean difference, $461; 95% CI, $236-$696). Thus, providing women with information alone did not affect treatment choices; however, the addition of an interview to clarify values and elicit preferences had a significant effect on women's management and resulted in reduced costs.

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Getting Back Into Shape After The Pregnancy

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