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• W2806866870 abstract "To assess the proportion of patients with symptomatic endometriosis satisfied with their medical treatment 12 months after enrollment in a stepped-care management protocol.Prospective, single-arm, self-controlled study.Academic department.A cohort of 157 consecutive patients referred or self-referred to our center for symptomatic endometriosis.Systematic detailed information process on medical and surgical treatment followed by a shared decision to start a stepped-care protocol including three subsequent medical therapy steps (oral contraception [OC]; 2.5 mg/d norethindrone acetate [NETA]; 2 mg/d dienogest [DNG]) and a fourth surgical step. Stepping up was triggered by drug inefficacy/intolerance.Satisfaction with treatment was assessed according to a five-category scale (very satisfied, satisfied, neither satisfied nor dissatisfied, dissatisfied, very dissatisfied). Variations were measured in pain symptoms with the use of a 0-10-point numeric rating scale (NRS), in quality of life with the use of the Short Form 12 questionnaire (SF-12), and in sexual functioning with the use of the Female Sexual Function Index (FSFI).At the end of the 12-month study period, 106 women were still using OC, 23 were using NETA, three were using DNG, and four had undergone surgery. Twenty-one participants (13%) dropped out from the study. In intention-to-treat analysis, excluding five drop-outs for pregnancy desire, the overall satisfaction rate with the stepped-care protocol was 62% (95/152; 95% CI 55%-70%). By 12-month follow-up, significant improvements were observed in all pain symptom scores and in SF-12 physical and mental component summary scores, whereas FSFI scores did not vary substantially.Most women with endometriosis-associated pelvic pain who chose a stepped-care approach were satisfied with OC and a low-cost progestin for the treatment of their symptoms. The need to step up to an expensive progestin or surgery was marginal." @default.
• W2806866870 created "2018-06-13" @default.
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• W2806866870 date "2018-06-01" @default.
• W2806866870 modified "2023-09-27" @default.
• W2806866870 title "A stepped-care approach to symptomatic endometriosis management: a participatory research initiative" @default.
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• W2806866870 doi "https://doi.org/10.1016/j.fertnstert.2018.01.037" @default.
• W2806866870 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/29871796" @default.

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