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• W3205288136 abstract "Study Objective To implement a One-Stop Menstrual Disorders Clinic (MDC) as recommended by the Heavy Menstrual Bleeding (HMB) NICE guidelines. Specific outcomes include numbers undergoing USS, outpatient hysteroscopy, treatments, discharge and cost effectiveness. Design Prospective audit of a database including all patients attending MDC from July 2020 - April 2021, extrapolating demographics, investigations, subsequent findings, management, and follow-up for each patient. Setting Outpatient One-Stop MDC which accommodates 20 patients per month within a health board of population 655,000 in which menstrual disorders account for 20% of gynaecology referrals. Patients or Participants Patients are vetted against urgent criteria as per NICE HMB guidance. A total of 103 patients were identified aged between 21-58 years. 57% patients had a BMI over 30. 22% patients had a medical condition that increased their risk of endometrial pathology. Interventions Introduction of the MDC which incorporates USS, outpatient hysteroscopy and treatment options in one-stop format compared to the traditional pathway which included attendance at gynaecology clinic; referral for ultrasound and admission for daycase hysteroscopy under general anaesthetic. Measurements and Main Results 102 patients had a TVUSS. Findings included: normal endometrium in 88%, proliferative in 1%, and suspicious in 5%. 16% patients had polyps and 15% had fibroids. 72% patients had a hysteroscopy. Findings included: normal endometrium in 88%; proliferative in 9%; and 5% were suspicious. 27% patients had polyps and 6% had fibroids 66% patients initiated treatments in clinic. 49% patients were discharged after one appointment, 23% were referred for outpatient Myosure, 4% for hysterectomy and 5% for hysteroscopy under general anaesthetic. Traditionally an USS and daycase hysteroscopy for 102 patients would cost £119,262. As a one stop clinic this cost £27,824. Conclusion The MDC has met the 2018 NICE recommendations by providing patients with gold standard assessment and investigations in a one-stop format resulting in efficient diagnosis, management, reduction in general anaesthetic and patient and health board costs. To implement a One-Stop Menstrual Disorders Clinic (MDC) as recommended by the Heavy Menstrual Bleeding (HMB) NICE guidelines. Specific outcomes include numbers undergoing USS, outpatient hysteroscopy, treatments, discharge and cost effectiveness. Prospective audit of a database including all patients attending MDC from July 2020 - April 2021, extrapolating demographics, investigations, subsequent findings, management, and follow-up for each patient. Outpatient One-Stop MDC which accommodates 20 patients per month within a health board of population 655,000 in which menstrual disorders account for 20% of gynaecology referrals. Patients are vetted against urgent criteria as per NICE HMB guidance. A total of 103 patients were identified aged between 21-58 years. 57% patients had a BMI over 30. 22% patients had a medical condition that increased their risk of endometrial pathology. Introduction of the MDC which incorporates USS, outpatient hysteroscopy and treatment options in one-stop format compared to the traditional pathway which included attendance at gynaecology clinic; referral for ultrasound and admission for daycase hysteroscopy under general anaesthetic. 102 patients had a TVUSS. Findings included: normal endometrium in 88%, proliferative in 1%, and suspicious in 5%. 16% patients had polyps and 15% had fibroids. 72% patients had a hysteroscopy. Findings included: normal endometrium in 88%; proliferative in 9%; and 5% were suspicious. 27% patients had polyps and 6% had fibroids 66% patients initiated treatments in clinic. 49% patients were discharged after one appointment, 23% were referred for outpatient Myosure, 4% for hysterectomy and 5% for hysteroscopy under general anaesthetic. Traditionally an USS and daycase hysteroscopy for 102 patients would cost £119,262. As a one stop clinic this cost £27,824. The MDC has met the 2018 NICE recommendations by providing patients with gold standard assessment and investigations in a one-stop format resulting in efficient diagnosis, management, reduction in general anaesthetic and patient and health board costs." @default.
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• W3205288136 date "2021-11-01" @default.
• W3205288136 modified "2023-10-18" @default.
• W3205288136 title "One Stop Menstrual Disorders Clinic: Introduction of a New Service." @default.
• W3205288136 doi "https://doi.org/10.1016/j.jmig.2021.09.372" @default.
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