Management of menorrhagia in primary care-impact on referral and hysterectomy: data from the Somerset Morbidity Project
| Autor: | Tom Fahey, Joyshri Sarangi, Clare Grant, Nicky Pearson, Lesley Gallier |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
medicine.medical_specialty Referral Epidemiology medicine.medical_treatment Hysterectomy Public Health Policy and Practice medicine Prevalence Humans Prospective Studies Practice Patterns Physicians' Prospective cohort study Menorrhagia Gynecology biology Primary Health Care Obstetrics business.industry Public health Public Health Environmental and Occupational Health Middle Aged biology.organism_classification England Tasa Observational study Female business Tranexamic acid medicine.drug |
| Zdroj: | Journal of epidemiology and community health. 54(9) |
| ISSN: | 0143-005X |
| Popis: | OBJECTIVE—To investigate the management of menorrhagia in primary care and its impact on referral and hysterectomy rates. DESIGN—Prospective observational study. SETTING—11 general practices from the Somerset Morbidity Project. SUBJECTS—885 women consulting their general practitioner with menorrhagia over four years. MAIN OUTCOME MEASURES—Proportions of these women investigated and treated with drugs in primary care, referred to a gynaecologist and undergoing operative procedures. The relation between investigation and prescribing in primary care and referral to and surgery in secondary care. RESULTS—Less than half of women had a vaginal examination (42%, 95% CI 39% to 45%), or a full blood count (39%, 95% CI 36% to 43%). Almost a quarter of women, 23% (95% CI 20% to 26%), received no drugs and 37% (95% CI 34% to 40%) received norethisterone. Over a third, 38% (95% CI 34% to 40%), of women were referred, and once referred 43% (95% CI 38% to 48%) of women were operated on. Women referred to a gynaecologist were significantly more likely to have received tranexamic acid and/or mefenamic acid in primary care (χ2=16.4, df=1, p |
| Databáze: | OpenAIRE |
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