Tailoring menopause education to the needs of primary care clinicians: the Oregon menopause ECHO experience

Objective: We aimed to conduct an educational needs assessment for practicing primary care clinicians using Project ECHO® (Extension for Community Healthcare Outcomes), a platform for telementoring healthcare professionals in rural and under-resourced areas. Methods: We conducted 12 weekly and monthly, 1-hour sessions comprised of brief didactics and facilitated discussions of real, deidentified cases. Didactic topics included perimenopause, mood, hormone and nonhormone therapies, genitourinary symptoms, and skeletal health. Feedback was obtained by preprogram, postprogram, and weekly surveys via REDCap. Participants rated the faculty-selected curriculum and discussions with Likert items. Qualitative assessment of participant comments, questions, case presentations, and chat discussions was performed to identify needs for additional educational topics. Results: Participants included 54 physicians and advanced practitioners from 17 of Oregon’s 36 counties, 1 urban, 7 urban/rural, 8 rural, and 1 frontier. The didactic content and case discussions were rated highly, with Likert scores of 5.3-5.5 (scale, 1-6), for being evidence-based, objective, and relevant. Confidence in performing targeted activities relating to menopause care was improved from scores of 2.0-2.6 (scale, 1-5) before the program to 3.7-3.9 after the program, P <0.01 for each comparison. We identified several topics for future curricula, including breast health, sexual dysfunction, weight management and abnormal vaginal bleeding. Conclusion: For these practicing primary care clinicians, the basic menopause curriculum was highly relevant, but greater depth and complexity were needed to address the characteristics of patients in their practices. The ECHO model was successful in addressing the menopause knowledge gap for diverse types of health care professionals.