Impact of patient information booklet on treatment decision--a randomized trial among women with heavy menstruation.

Objective: Does a patient information booklet influence treatment for menorrhagia?

Design: Randomized trial and a pre-trial prospective cohort study.

Setting: Gynaecology outpatient clinics in 14 Finnish hospitals.

Participants: A total of 363 (randomized trial) plus 206 (cohort study) patients with menorrhagia.

Intervention: An information booklet about menorrhagia and treatment options, mailed before the first visit to the outpatient clinic.

Main Outcome Measures: Distribution of treatment modalities, knowledge about treatment options, satisfaction with communication with personnel and anxiety.

Results: Treatment decision within 3 months was made more often in the intervention group than in the control group (96% and 89% respectively, P = 0.02). Oral medication was more frequently chosen, and newly introduced treatments (minor surgery, hormonal intrauterine system) were less frequently used in the intervention group (at 3-month follow-up 21% and 29%, respectively). The differences persisted at the 12-month follow-up. In the pre-trial group, new treatment methods were less frequently chosen and used than in the control group. Additional information did not increase the number of surgical procedures used, improve knowledge, or influence satisfaction or anxiety.

Conclusions: Additional information led to an increase in specific treatment decisions and changed the distribution of used treatments without increasing the number of surgical procedures. The study suggests that well-informed women adopting an active role may counteract physicians' emphasis on newly introduced treatments.