Stop the bleeding and fill the tank: A retrospective chart review comparing primary care workup and management of abnormal uterine bleeding to practice guidelines among patients referred to gynecology
CANSAGE ePoster Library. Grisdale M. 09/27/19; 279820; eP-138
Mackenzie Grisdale
Mackenzie Grisdale
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Objectives: To evaluate the extent to which primary care workup and initial management of patients referred to gynecology for abnormal uterine bleeding (AUB) reflect current SOGC guidelines as a basis for improving triaging and response to these referrals.Methods: Retrospective review of electronic charts of patients referred to ten gynecologists at one hospital in Hamilton, Ontario over a 6 month period. Charts were pulled based on billing codes most likely to capture AUB referrals for reproductive aged women. 310 patients were included after 478 charts were reviewed. Data on primary care workup and management were extracted, including whether patients had CBCs, iron therapy, ultrasounds, endometrial biopsies and initial management. Data were analyzed using descriptive statistics.Results: Approximately 25% of patients had workup and management grossly reflecting SOGC guidelines prior to seeing gynecology, meaning they had CBCs, iron therapy (if anemic), ultrasounds, and management initiated. Overall, 62% of patients had CBCs, 80% had ultrasounds, and 52% had management initiated prior to the first specialist visit. In terms of anemia, 35% were not currently anemic, 10% had a hemoglobin of 110-119 g/L, 13.5% had a hemoglobin of 80-109, and 3.5% had a hemoglobin below 80.Conclusion: The study provides a baseline of how primary care patients are investigated and managed for AUB prior to assessment by gynecologists. These data have led to development of a new process for responding to and triaging referrals for AUB at the site of this study.
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