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Clinical Evaluation Results
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Results of the TalkToYourDoc Clinical Evaluation

  • The TalkToYourDoc hormone replacement and menopause module was developed and tested with Small Business Innovation Research (SBIR) grants from the National Institutes of Health, National Institute on Aging.
  • The clinical evaluation was conducted at the Medical College of Wisconsin in the Departments of Obstetrics & Gynecology and Family & Community Medicine.
  • The results of this study have been published in Journal of Women's Health, January 2008.

Purpose of the Study

The purpose of the clinical evaluation was to determine if the TalkToYourDoc (TTYD) hormone replacement therapy and menopause module can provide benefit to health care communication between a patient and her health care provider. The TTYD module is a questionnaire based on proprietary algorithms and accessed through the Internet. Women can complete the questionnaire on their home computer or any computer connected to the Internet. After the questionnaire is completed, TalkToYourDoc generates a customized medical history and set of individualized questions that the patient prints and takes to her appointment to discuss with her health care provider.

Specifically, TalkToYourDoc was shown to:

  • improve communication during the office visit
  • improve satisfaction with the discussion of HRT for both the provider and the patient
  • contribute to a better understanding of the health issue on the part of the patient
  • create a more efficient office visit for both doctors and patients

The Study Design

The Patients

  • Women who were menopausal or nearing menopause were recruited into the study. 50% were randomly assigned to use the TTYD web-based tool and 50% randomly assigned to the usual care group.
  • The women in the intervention group were given access to the TTYD web-based tool and were instructed to bring the printout generated by the questionnaire to the clinic appointment for discussion with their health care provider.
  • The women in the usual care group were instructed to discuss hormone therapy with their health care provider at their next clinic appointment.
  • 288 women participated in the study (141 women in the intervention group and 147 in the usual care group)
    • average age: 52.5 years
    • race/ethnicity: 92% white; 8% nonwhite
    • educational level: 84% greater than high school

The Health Care Providers

  • 24 were Medical Doctors
  • 4 were Nurse Practitioners
  • 53% were men
  • 47% were women

Results

Patient Evaluation of TTYD

  • Women who used TTYD were significantly more likely to bring appropriate questions to the clinic appointment compared to the women who did not use TTYD
  • Of the women who used TTYD:
    • 89% reported the website questionnaire to be extremely or very easy to use
    • 73% reported that the questions generated by the questionnaire were extremely or very useful
    • 93% said the printout they took to their doctor was either extremely, very, or somewhat helpful in discussing hormone replacement therapy with their health care provider
    • 71% said their health care provider had a positive response to reviewing the printout
    • 86% said the TTYD module was either extremely, very, or somewhat helpful regarding a decision about HRT
    • 97% of these women indicated that they were at least somewhat experienced with a computer

Health Care Provider Evaluation

  • Compared to women who did not use TTYD, providers who met with women who had used TTYD reported that these women were significantly more likely to:
    • have relevant questions regarding HRT
    • be engaged in the discussion of HRT
    • bring more relevant medical history information with them
    • be more satisfied with the discussion regarding HRT
  • Compared to the visits with women who did not use TTYD, providers who met with the women who used TTYD reported:
    • significantly higher level of efficiency for the office visit
    • significantly better communication with the women
  • Health care provider assessment of the visits where women used the TTYD module and brought the printout to the appointment indicated the following:
    • 89% - the medical history was accurate and helpful
    • 82% - the questions generated were extremely or somewhat appropriate
    • 99% - the patient seemed satisfied with the discussion involving the printout
    • 87% - would recommend TTYD website and printout to other patients

Importantly, while the intervention appointments involved shared decision making, there was no difference in length of time for intervention and control appointments, both being about 20 minutes.

Conclusion

The TTYD web-based questionnaire and resulting medical history and printout a patient takes to her doctor visit improves communication, satisfaction and visit efficiency. The questionnaire is easy to use, produces useful and appropriate questions, provides an accurate and helpful medical history, and facilitates the decision-making process involving hormone therapy.

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