For women facing menopause, the choice to take — or not take — hormone replacement therapy can be overwhelming, complicated and downright stressful. It turns out, clinicians often struggle with the decision-making process, too. Now, a new mobile app could help both women and their clinicians navigate this important health care decision.
The app, called MenoPro, was developed by JoAnn Manson, MD, MPH, DrPH, chief of the Division of Preventive Medicine at BWH, and her colleagues at the North American Menopause Society (NAMS). It is designed to help clinicians and patients work together to personalize treatment decisions based on patients’ own preferences (hormonal vs. non-hormonal therapies, if lifestyle modifications don’t relieve symptoms) and to take into account their health risks (such as diabetes, high blood pressure, high cholesterol and cardiovascular disease). The app features two modes, one for health care providers and another for patients.
“This is a clinical decision support tool that facilitates shared decision-making between women and their clinicians, leading to more informed and individualized choices,” said Manson.
The app is now available for free and can be downloaded on iPhones, iPads and other Apple devices, and will soon be available for Android devices. It is based on an algorithm, which Manson and her colleagues developed and subsequently published in the journal Menopause, and harnesses the most up-to-date science on menopause symptom management. The app does not allow pharmaceutical advertising and was developed without industry support.
In the app’s “patient” mode, patients can access a range of educational materials, including behavioral lifestyle strategies for reducing hot flashes, advantages and disadvantages of hormonal versus non-hormonal therapies, and transdermal versus oral hormone therapy. It also asks patients how long ago they went through menopause and whether they have diabetes, elevated cholesterol, high blood pressure or other heart disease risk factors. With this information, the app would discourage hormone therapy for patients deemed to be at high risk for cardiovascular disease, for example, and would recommend a non-hormonal treatment option.
In the app’s “healthcare provider” mode, clinicians can use risk calculators to determine a patient’s risk for cardiovascular disease, breast cancer and bone fractures and how these risks can influence treatment decisions.
MenoPro was presented at the NAMS recent annual meeting in Washington, D.C.
“The app has already been downloaded by several thousand users, and the feedback to date has been overwhelmingly positive,” said Manson.