Evaluating the Effects of Symptom Monitoring on Menopausal Health Outcomes: A Systematic Review and Meta-Analysis

Abstract

Evidence suggests that monitoring and appraising symptoms can result in increased engagement in medical help-seeking, improved patient-doctor communication, and reductions in symptom prevalence and severity. To date, no systematic reviews have investigated whether symptom monitoring could be a useful intervention for menopausal women. This review explored whether symptom monitoring could improve menopausal symptoms and facilitate health-related behaviours. Results suggested that symptom monitoring was related to improvements in menopausal symptoms, patient-doctor communication and medical decision-making, heightened health awareness, and stronger engagement in setting treatment goals. Meta-analyses indicated large effects for the prolonged use of symptom diaries on hot flush frequencies. Between April 2019 and April 2021, PsychInfo, EMBASE, MEDLINE, CINAHL, Cochrane, ProQuest, PsychArticles, Scopus, and Web of Science were searched. Eighteen studies met the eligibility criteria and contributed data from 1,718 participants. Included studies quantitatively or qualitatively measured the impact of symptom monitoring on menopausal populations and symptoms. Research was narratively synthesised using thematic methods, 3 studies were examined via meta-analysis. Key themes suggest that symptom monitoring is related to improvements in menopausal symptoms, improved patient-doctor communication and medical decision-making, increased health awareness, and stronger engagement in goal-setting behaviours. Meta-analysis results indicated large effects for the prolonged use of symptom diaries on hot flush frequency: 0.73 [0.57, 0.90]. This review is limited due to the low number of studies eligible for inclusion, many of which lacked methodological quality. These results indicate that symptom monitoring has potential as an effective health intervention for women with menopausal symptoms. This intervention may be beneficial within healthcare settings, in order to improve patient-doctor relations and adherence to treatment regimes. However, findings are preliminary and quality assessments suggest high risk of bias. Thus, further research is needed to support these promising outcomes.Systematic Review Registration Number:https://www.crd.york.ac.uk/prospero/display_record.php?, PROSPERO, identifier: CRD42019146270.

Symptom monitoring improves physical and emotional outcomes during menopause: a randomized controlled trial

“…The present study suggested that health-related behaviors, such as health communication, self-efficacy, decision making, and help-seeking intentions, were not influenced by symptom monitoring. This finding contrasts with results from Andrews et al 1 who demonstrated that symptom monitoring could lead to improvements in these behaviors. One reason for this outcome could be due to the 2-week research period used by the present study, which may not have been enough to time to alter health-related behaviors.…”

“…The result that symptom monitoring reduced physical symptoms is supportive of previous findings. The systematic review conducted by Andrews et al 1 demonstrated that using symptom diaries had a large effect on reducing hot flush frequency scores via meta-analyses, and qualitative findings suggested that symptom diaries could improve symptoms relating to depression, headaches, and urinary incontinence. Supporting these outcomes, the present study indicated that night sweats and headaches were positively influenced by the symptom monitoring intervention.…”

“…A recent systematic review 1 indicated that symptom monitoring could reduce menopausal symptoms and improve health-related behaviors such as health awareness, help seeking, patient-doctor communication, medical decision making, and treatment goal setting, all of which are antecedents for improved health outcomes. 2 The present study was developed in line with "Phase II: The Exploratory Trial" stage of the Medical Research Council framework to experimentally test the intervention effects of symptom monitoring during menopause.…”

The Health & Her App is Associated with Improved Symptom Outcomes Among 1,900 Menopausal Women

“…These findings remained significant after controlling for covariates such as HRT use, hormonal contraceptive use, supplement use, age, and current comorbidities. These findings are in line with prior research in the field of female health which has demonstrated that symptom monitoring during menopause and use of digital health apps which enable period logging and digital health promoting activities are associated with health improvements (5,6,3,4).…”

“…In our study, the total number of days spent monitoring symptoms independently predicted symptom reductions. This is in-line with prior research which has demonstrated that symptom monitoring can result in reductions in menopausal symptoms (5,6). However, combined weekly engagement with the app was associated with greater reductions in symptoms than symptom monitoring alone, suggesting that using multiple facets of the Health & Her app can bestow greater benefits to the user.…”