Treatment Choices in a National Cohort of Canadian Women With Symptomatic Uterine Fibroids
| Autor: | Nicholas Leyland, Sari Kives, John Ashkenas, Tim Strand, John Thiel, Peter Janiszewski |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Canada Norpregnadienes Uterine fibroids medicine.medical_treatment Population Hysterectomy Gonadotropin-Releasing Hormone 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Quality of life Pregnancy Ulipristal acetate Uterine Myomectomy medicine Contraceptive Agents Female Humans 030212 general & internal medicine education Watchful Waiting education.field_of_study 030219 obstetrics & reproductive medicine Leiomyoma business.industry General surgery Obstetrics and Gynecology Middle Aged medicine.disease Treatment Outcome chemistry Contraceptive Agents Hormonal Uterine Neoplasms Female business Watchful waiting |
| Zdroj: | Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC. 42(12) |
| ISSN: | 1701-2163 |
| Popis: | Objectives To describe treatment choices made at the time of enrollment in CAPTURE, a Canadian patient registry for women with symptomatic uterine fibroids (UFs), and to define demographic and clinical characteristics that independently predict these choices. Methods Women arranging appointments for UF care were eligible to enrol. At the time of the enrollment visit, women's self-reported treatment histories were noted, along with their clinical characteristics. Tretment options were discussed and chosen during that visit. Patients could choose medical and/or surgical treatment, or they could opt for no active treatment (i.e., "watchful waiting"); treatment decisions were not binding. Results The most common medication proposed and chosen was ulipristal acetate (UPA), and the most common procedure was myomectomy. These treatments were also the most commonly identified in patients' histories. Medication alone and medication in combination with surgery were the most common treatment approaches chosen (46% and 26%, respectively). Surgery alone and watchful waiting were chosen by 14% and 13% of patients, respectively. Significant predictors of active treatment included patient pregnancy plans, overall symptom severity, and prior treatment history (medical and surgical). Other parameters, including patient age and history of specific UF symptoms, appear to influence the choice of medical therapies (UPA, gonadotropin-releasing hormone agonists, or other options) and procedures (myomectomy or hysterectomy). Conclusions This real-world study documents the patient factors associated with the treatment decisions of women seeking care for symptomatic UFs in contemporary Canadian gynaecology practice. Subsequent analyses will follow the outcomes of these treatments over two years in this population. |
| Databáze: | OpenAIRE |
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