Direct to Consumer
Background: Shared decision making is a collaborative process that allows patients and their providers to make health care decisions together. It takes into account the best clinical evidence available, as well as the patient's values and preferences.
Perimenopausal women would benefit from shared decision making with their providers regarding menopause because of its sensitive nature.
Purpose: To evaluate the feasibility of the Veterans Health Administration's patient portal "My HealtheVet" as an educational platform for women Veterans with menopause and assess its impact on menopause knowledge and shared decision making.
Methods: We enrolled 140 women ages 45-60 in the Miami Veteran Affairs Healthcare System; participants' weekly usage of My HealtheVet and received brief factsheets about communicating with their providers, menopause, and menopause associated symptoms and their treatment. Participants also received the Women's Health Questionnaire monthly about their menopause symptoms. The participants' usage of My HealtheVet was tracked using the weekly responses, read receipt reports, and monthly Women's Health Questionnaire completion. Participants were surveyed at 6 months regarding knowledge and shared decision making.
Results: Of the 140 women enrolled in the project, 56 completed both baseline and follow-up surveys. Average participant age was 53, 80.4% Non-Hispanic, 19.6% Hispanic; 35.7% White, 44.6% Black, 71.4% had a college education, 19.6% had attended graduate school. All the women reported previous computer, Internet, and search engine use. Of the 140 participants who received weekly messages, 13 to 91 (based on read receipts) read their messages, while 5 to 15 responded. Overall 10,587 messages were sent out and 673 were received.
The women self-rated their knowledge about menopause on a 1-10 Likert scale; their average knowledge score before participation in the program was 5, after participating in the program their average knowledge score increased to 8. In addition, fifty-six women completed a pre- and post-intervention 18-item true-false menopause knowledge test; 31 (55.4%) had an increase in score, and the average score on the knowledge increased from 81.7% to 87.8%.
When surveyed regarding shared decision making, 34 (60.7%) women reported that they would definitely use it for important health decisions and 19 (33.9%) said they probably would. Fifty-one (91.1%) stated they felt confident in discussing menopause treatments with their providers, thereby initiating the process of shared decision making.
Regarding communication with their providers, 30 (45.5%) women stated that they prepare a list of questions for their doctor; 48 (72.7%) ask questions when they don't understand; and 23 (34.8%) discuss personal problems related to their illness during face-to-face visits.
Conclusions: A need exists for increased communication regarding menopause between patients and providers. Patient portals offer a feasible and economical tool to enhance patient knowledge of menopause and shared decision making. Such interventions using patient portals can also foster interactive shared decision making via use of secure messaging and during visits with providers.
South Florida VA Reseach Foundations
Berry Thavalathil, developed a passion for medicine, finished her MD in Tribhuvan University, Nepal, and has worked in underserved areas. She completed her US medical licensing exams and got certified with Educational Commission for Foreign Medical Graduates, Philadelphia. Her interest in research helped her to gain experience in University of Cincinnati. She is currently working as a research coordinator in an educational project in Miami Miami VA Healthcare System while pursuing her medical residency.
Miami VA Healthcare System
Diana Ruiz is a Registered Nurse in GRECC at the Miami VA Healthcare System. She received her Bachelor of Science in Nursing from Florida International University.
Miami VA Healthcare System
Dr. Silvina Levis, MD, is Professor of Medicine at the University of Miami and physician-investigator in the GRECC at the Miami VAHS. Dr. Levis is an endocrinologist with expertise in the care of older women. She was founder and director of the Osteoporosis Center (1994-2014), a joint program between the UM and the Miami VAHS. As an endocrinologist, Dr. Levis has extensive experience in the management of menopausal women. She is PI of the project “Technology and Collaborative Care Improve the use of Hormone Therapy in Postmenopausal Women Veterans” to educate women and improve the management of vasomotor symptoms and vulvovaginal atrophy. Dr. Levis is currently a member of the National Institute of Health’s Aging Systems and Geriatrics Study Section. She is also a member of VHA’s Women’s Health Practice-Based Research Network Consortium and VA Reproductive Health Working Group, and was invited to the 2014 National VA Women’s Health Research Conference.
Miami VA Healthcare System
Dr. Dang is Physician, a Researcher, and the Assocoate Director for Implementation and Outcomes Research in the Miami VA Geriatrics Research Education and CLinical Ceneter (GRECC). She is also an Associate Professor of Clinical Medicine in the Division of Geriatrics and Palliative Medicine in the Miller School of Medicine’s Department of Medicine, at the University of Miami. Dr. Dang earned an M.B.B.S degree from the University of Delhi, India, completed her residency in Internal Medicine from Rochester, NY, and her fellowship in Geriatrics from Little Rock, AR. She also has an MPH degree from Tulane University. Dr. Dang is a geriatrician with an interest in models of care for patients with chronic diseases, specifically using telehealth and care coordination. She has been involved with telehealth since its inception in the VA. She has extensive experience in the design and implementation of telehealth programs for elderly patients with chronic diseases such as diabetes, heart failure, dementia, and hypertension. She has led and supported various grants to develop and study home telehealth, web, cellular phone, or patient health record based interventions for supporting patients and their caregivers. Her grants attempt to establish usability and utility of technology, and evaluate impact on care, efficacy, and disease specific outcomes.
Sunday, April 23
3:00 PM – 4:00 PM
Mr. Carlos A. Gomez-Orozco
Miami VA Medical Center, GRECC
I graduated with a degree in Exercise Science from Minnesota State University in Mankato, Minnesota. Before I graduated I was given the opportunity to work with a physical therapist at the Miami VA Medical center in the Center of Excellence in Spinal Cord Injury Research for the summer of 2004. While there I worked on several different studies, including a resistance training study with spinal cord injury patients where I worked directly with the study subjects. Since then I have worked on a wide variety of research projects as a Research Program Coordinator at the Miami VA Medical Center.