Real-world characteristics of women with endometriosis-related pain entering a multidisciplinary endometriosis program
Abstract Background Women with endometriosis are commonly treated by their sole provider. In this single-provider model of care, women frequently report long diagnostic delays, unresolved pelvic pain, multiple laparoscopic surgeries, sequential consultations with numerous providers, and an overall d...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Women's Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12905-020-01139-7 |
| _version_ | 1818452951581065216 |
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| author | Sanjay K. Agarwal Oscar Antunez-Flores Warren G. Foster Ashwaq Hermes Shahrokh Golshan Ahmed M. Soliman Amanda Arnold Rebecca Luna |
| author_facet | Sanjay K. Agarwal Oscar Antunez-Flores Warren G. Foster Ashwaq Hermes Shahrokh Golshan Ahmed M. Soliman Amanda Arnold Rebecca Luna |
| author_sort | Sanjay K. Agarwal |
| collection | DOAJ |
| description | Abstract Background Women with endometriosis are commonly treated by their sole provider. In this single-provider model of care, women frequently report long diagnostic delays, unresolved pelvic pain, multiple laparoscopic surgeries, sequential consultations with numerous providers, and an overall dissatisfaction with care. The emergence of multidisciplinary endometriosis centers aims to reduce diagnostic delays, improve pain management, and promote patient satisfaction; however, baseline data at the time of presentation to a multidisciplinary center are lacking. Methods A real-world, retrospective, single-site, cross-sectional study of women with surgically confirmed and/or clinically diagnosed endometriosis generated baseline data for a planned longitudinal assessment of multidisciplinary care of endometriosis. The primary objective was to determine the proportion of patients experiencing mild, moderate, or severe pain for dysmenorrhea, non-menstrual pelvic pain (NMPP), and dyspareunia at entry into a multidisciplinary endometriosis clinic. Also explored were relationships between pain scores and clinical endpoints obtained from electronic medical records. Results More than half (59%) of the study participants (n = 638) reported experiencing pelvic pain for ≥ 5 years. Pain intensity was highest for patients reporting dysmenorrhea, followed by NMPP, and dyspareunia. Significant correlations were observed between total pelvic pain and patient age (r = –0.22, p < 0.001, n = 506) and number of previous healthcare providers (r = 0.16, p = 0.006, n = 292); number of previous providers and duration of pain (r = 0.21, p = < 0.0001, n = 279); and duration of pain and years since diagnosis (r = 0.60, p < 0.001, n = 302). Mean pain scores differed significantly by age group for dysmenorrhea (p < 0.001), NMPP (p = 0.005), and total pelvic pain (p < 0.001), but not for dyspareunia (p = 0.06), with the highest mean pain scores reported among those < 30 years of age. Conclusion These real-world data indicate that in the single-provider model of care, unresolved pelvic pain is common among women with endometriosis. Alternative care models, including a multidisciplinary approach, need to be evaluated for improvements in clinical outcomes. These data also highlight the importance of addressing NMPP, which may be particularly troublesome for patients. |
| first_indexed | 2024-12-14T21:31:15Z |
| format | Article |
| id | doaj.art-72fbba58129e415fb6aa668c01f6ba77 |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-12-14T21:31:15Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-72fbba58129e415fb6aa668c01f6ba772022-12-21T22:46:42ZengBMCBMC Women's Health1472-68742021-01-0121111410.1186/s12905-020-01139-7Real-world characteristics of women with endometriosis-related pain entering a multidisciplinary endometriosis programSanjay K. Agarwal0Oscar Antunez-Flores1Warren G. Foster2Ashwaq Hermes3Shahrokh Golshan4Ahmed M. Soliman5Amanda Arnold6Rebecca Luna7Center for Endometriosis Research and Treatment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San DiegoWomen’s Health, US Medical Affairs, AbbVie Inc.Department of Obstetrics and Gynecology, and the School of Biomedical Engineering, McMaster UniversityWomen’s Health, US Medical Affairs, AbbVie Inc.Department of Psychiatry, University of CA, San DiegoHealth Economics and Outcomes Research, AbbVie Inc.Center for Endometriosis Research and Treatment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San DiegoCenter for Endometriosis Research and Treatment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San DiegoAbstract Background Women with endometriosis are commonly treated by their sole provider. In this single-provider model of care, women frequently report long diagnostic delays, unresolved pelvic pain, multiple laparoscopic surgeries, sequential consultations with numerous providers, and an overall dissatisfaction with care. The emergence of multidisciplinary endometriosis centers aims to reduce diagnostic delays, improve pain management, and promote patient satisfaction; however, baseline data at the time of presentation to a multidisciplinary center are lacking. Methods A real-world, retrospective, single-site, cross-sectional study of women with surgically confirmed and/or clinically diagnosed endometriosis generated baseline data for a planned longitudinal assessment of multidisciplinary care of endometriosis. The primary objective was to determine the proportion of patients experiencing mild, moderate, or severe pain for dysmenorrhea, non-menstrual pelvic pain (NMPP), and dyspareunia at entry into a multidisciplinary endometriosis clinic. Also explored were relationships between pain scores and clinical endpoints obtained from electronic medical records. Results More than half (59%) of the study participants (n = 638) reported experiencing pelvic pain for ≥ 5 years. Pain intensity was highest for patients reporting dysmenorrhea, followed by NMPP, and dyspareunia. Significant correlations were observed between total pelvic pain and patient age (r = –0.22, p < 0.001, n = 506) and number of previous healthcare providers (r = 0.16, p = 0.006, n = 292); number of previous providers and duration of pain (r = 0.21, p = < 0.0001, n = 279); and duration of pain and years since diagnosis (r = 0.60, p < 0.001, n = 302). Mean pain scores differed significantly by age group for dysmenorrhea (p < 0.001), NMPP (p = 0.005), and total pelvic pain (p < 0.001), but not for dyspareunia (p = 0.06), with the highest mean pain scores reported among those < 30 years of age. Conclusion These real-world data indicate that in the single-provider model of care, unresolved pelvic pain is common among women with endometriosis. Alternative care models, including a multidisciplinary approach, need to be evaluated for improvements in clinical outcomes. These data also highlight the importance of addressing NMPP, which may be particularly troublesome for patients.https://doi.org/10.1186/s12905-020-01139-7EndometriosisPainReal-word evidenceMultidisciplinary approach |
| spellingShingle | Sanjay K. Agarwal Oscar Antunez-Flores Warren G. Foster Ashwaq Hermes Shahrokh Golshan Ahmed M. Soliman Amanda Arnold Rebecca Luna Real-world characteristics of women with endometriosis-related pain entering a multidisciplinary endometriosis program BMC Women's Health Endometriosis Pain Real-word evidence Multidisciplinary approach |
| title | Real-world characteristics of women with endometriosis-related pain entering a multidisciplinary endometriosis program |
| title_full | Real-world characteristics of women with endometriosis-related pain entering a multidisciplinary endometriosis program |
| title_fullStr | Real-world characteristics of women with endometriosis-related pain entering a multidisciplinary endometriosis program |
| title_full_unstemmed | Real-world characteristics of women with endometriosis-related pain entering a multidisciplinary endometriosis program |
| title_short | Real-world characteristics of women with endometriosis-related pain entering a multidisciplinary endometriosis program |
| title_sort | real world characteristics of women with endometriosis related pain entering a multidisciplinary endometriosis program |
| topic | Endometriosis Pain Real-word evidence Multidisciplinary approach |
| url | https://doi.org/10.1186/s12905-020-01139-7 |
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