10. Improving counseling on treatment options for heavy menstrual bleeding via an educational aid: a pilot study

Background

Heavy menstrual bleeding (HMB) affects a significant number of reproductive-aged adolescents assigned female at birth (AFAB). There is limited literature examining the use of educational aids (EDA) or videos for adolescent patients initiating hormonal treatment for HMB. EDA could help to eliminate bias and ensure patients receive high-quality information. We hypothesized that use of an EDA would be non-inferior to traditional counseling from a Pediatric and Adolescent Gynecology (PAG) physician on patient's knowledge of treatment options and confidence in method selection

Methods

This is a prospective, randomized controlled trial. IRB approval was obtained. An EDA was created by the PAG department within our institution. Patients AFAB ages 11-21 presenting with a complaint of HMB were recruited to the study. Participants completed a short demographic and knowledge survey and were randomized based on medical record number to traditional versus EDA counseling. Traditional counseling was performed by PAG attendings or fellows. After EDA or traditional counseling, participants completed an additional survey of questions assessing their counseling experience, knowledge of options, and their decision-making process

Results

17 patients were recruited, 8 in the EDA group and 9 in the traditional group. There were no differences between groups in patient ages, race or ethnicity (Table 1). Patients in both groups felt the amount of information they received was “perfect” (p=.76). Patients in the traditional group felt they received more new information compared to the EDA group (p=.02) (Table 1). Both groups felt they learned equally about all options (p=.28). The EDA group answered more post-survey knowledge questions correctly on average compared to the traditional group (p= .02) (Table 1). The traditional counseling group felt significantly more confident than the EDA group when choosing a method (p=.02), though both groups fell into the “confident” range

Conclusions

Patients learned equally about options in both the EDA and traditional counseling groups but felt more confident about choosing an option in the traditional group. EDAs may be a useful tool to eliminate potential bias, improve efficiency in clinic, and increase adolescents’ confidence in making health care choices