Objective To determine whether an educational package could influence the management of menorrhagia, increase the appropriateness of choice of non-hormonal treatment, and reduce referral rates from primary to secondary care.
Setting General practices in East Anglia.
Subjects 100 practices (348 doctors) in primary care were recruited and randomised to intervention (54) and control (46).
Interventions An educational package based on principles of « academic detailing » with independent academics was given in small practice based interactive groups with a visual presentation, a printed evidence based summary, a graphic management flow chart, and a follow up meeting at 6 months.
Outcome measures All practices recorded consultation details, treatments offered, and outcomes for women with regular heavy menstrual loss (menorrhagia) over 1 year.
Results 1001 consultation data sheets for menorrhagia were returned.
There were significantly fewer referrals (20% v 29% ; odds ratio 0.64 ; 95% confidence interval 0.41 to 0.99) and a significantly higher use of tranexamic acid (odds ratio 2.38 ; 1.61 to 3.49) in the intervention group but no overall difference in norethisterone treatment compared with controls.
There were more referrals when tranexamic acid was given with norethisterone than when it was given alone.
Those practices reporting fewer than 10 cases showed the highest increase in prescribing of tranexamic acid. (...)
Mots-clés Pascal : Ménorragie, Conduite à tenir, Programme enseignement, Médecin généraliste, Evaluation performance, Pratique professionnelle, Royaume Uni, Europe, Homme, Hémorragie, Appareil génital femelle pathologie, Utérus pathologie, Cycle menstruel pathologie
Mots-clés Pascal anglais : Menorrhagia, Clinical management, Educational program, General practitioner, Performance evaluation, Professional practice, United Kingdom, Europe, Human, Hemorrhage, Female genital diseases, Uterine diseases, Menstruation disorders
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0270172
Code Inist : 002B30A09. Création : 16/11/1999.