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First-line management of menorrhagia: Findings from a survey of general practitioners in Forth Valley
  1. Elaine Turner, MB ChB, General Practitioner1,
  2. Paul Bowie, BA, PgDip, Clinical Effectiveness Co-ordinator2,
  3. Kathleen W McMullen, MB BS, MRCOG, MRCS, Consultant Obstetrician and Gynaecologist2 and
  4. Catriona Kellock, BSc, RGN, Guidelines Facilitator3
  1. Killin Medical Practice, Perthshire, Scotland, UK
  2. Obstetrician and Gynaecologist, Stirling Royal Infirmary, Stirling, Scotland, UK
  3. Guidelines Facilitator, Forth Valley Health Board, Stirling, Scotland, UK
  1. Correspondence Dr Elaine Turner, Killin Medical Practice, Laggan Leigheas, Killin, Perthshire, FK21 8TQ, UK. Tel: 01567 820213

Abstract

This study was undertaken to determine local GPs' current management of menorrhagia, prior to the release of the Royal College of Obstetricians and Gynaecologists' (RCOG) guideline on the initial management of menorrhagia. A postal questionnaire was sent to 204 GPs in the Forth Valley area. An 84% (n = 173) response rate was recorded. Responses were compared with RCOG guideline recommendations after its release. Fifty-two percent of respondents measured a full blood count and 56% performed a pelvic examination. Two thirds of GPs chose the recommended treatments (mefenamic acid or tranexamic acid) as their first or second choice of treatment in women not requiring contraception. One third chose cyclical progestogens. Only 10% of GPs selected an ineffective treatment (cyclical progestogens) as their first or second choice of treatment in women requiring contraception. This survey demonstrates that the majority of GPs are already prescribing the treatments recommended in the RCOG guidelines. There is a need for education amongst a minority to improve their practice. Half of the GPs reported compliance with the recommended investigations of full blood count and pelvic examination. The point at which these investigations are performed in the initial management of menorrhagia may need further discussion between primary and secondary care clinicians to clarify their purpose.

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