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Vol. 81, No. 3, 2014
Issue release date: April 2014
Section title: Original Paper
Horm Res Paediatr 2014;81:182-188
(DOI:10.1159/000356920)

Exploring Clinician Confidence in the Management of Adolescent Menstrual and Reproductive Health Problems

Neylon O.M. · Grover S.R. · Zacharin M.
Departments of aEndocrinology and bGynaecology, Murdoch Childrens Research Institute and The Royal Children's Hospital, Melbourne, Vic., Australia

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/10/2013 10:56:13 AM
Accepted: 10/11/2013
Published online: 2/4/2014

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 1

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: http://www.karger.com/HRP

Abstract

Purpose: A high incidence of menstrual problems is reported in adolescent girls, with significant attendant morbidity. The majority are likely to be seen and managed by doctors other than specialist gynaecologists. This study aimed to survey the practice of doctors other than gynaecologists, to establish their chosen therapeutic options and confidence levels and to explore knowledge, using clinically challenging scenarios. Methods: A questionnaire designed to fulfil the above aims was distributed to a wide range of clinicians across paediatric disciplines and primary care. Results: The questionnaire was returned by 306 clinicians. General practitioners and paediatric endocrinologists were more confident in management and were more likely to self-manage patients (p < 0.01). The oral contraceptive pill was the most frequently chosen first-line therapy by all clinicians, followed by transdermal oestrogen/progesterone, etonorgestrel implant, progesterone-only pills, levonorgestrel-intrauterine system and depot medroxyprogesterone acetate injections. General, community and subspecialist paediatricians were more likely to choose suboptimal management strategies for each of five clinical scenarios. Conclusions: Low confidence levels, suboptimal therapy choices and high referral rates are common among general paediatricians, community paediatricians and subspecialists for adolescents with menstrual and reproductive health concerns. Targeted education for these clinician groups, towards optimizing management for these patients, would enhance care.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/10/2013 10:56:13 AM
Accepted: 10/11/2013
Published online: 2/4/2014

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 1

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: http://www.karger.com/HRP


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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