Park S, Farquhar C M
Department of Obstetrics and Gynaecology, National Women's Hospital, University of Auckland, New Zealand.
Aust N Z J Obstet Gynaecol. 2002 Oct;42(4):374-8. doi: 10.1111/j.0004-8666.2002.00376.x.
To survey the practice preferences and the attitudes of New Zealand gynaecologists, general practitioners and family planning doctors to Guidelines for the Management of Heavy Menstrual Bleeding.
A postal survey collected information on the following: demographics, practice preferences, knowledge of, usage of and attitudes toward the Guidelines for the Management of Heavy Menstrual Bleeding. The survey was sent to randomly selected practising general practitioners (n = 531), all specialist gynaecologists (n = 194) and all Family Planning Association doctors (n = 69) in New Zealand. Replies were received from 441 (56%).
The preferred first choice for the management of heavy menstrual bleeding by general practitioners and family planning doctors was nonsteroidal anti-inflammatory medications (23%). Tranexamic acid was the preferred first choice medication for the management of heavy menstrual bleeding by specialists (57%), and preferred second choice (as well as levonorgestrel intrauterine system) by general practitioners and family planning doctors (34%). Barriers identified by general practitioners and family planning doctors to implementing the guideline included inability to access ultrasound scanning and specialist services, and a lack of subsidy for tranexamic acid and the levonorgestrel intrauterine system.
There has been a change in prescribing patterns since 1995 among specialist and general practitioners and family planning doctors in New Zealand in accordance with the Guidelines for the Management of Heavy Menstrual Bleeding. Further attention to reducing barriers should focus on increasing access to ultrasound scanning, specialist services and subsidising the levonorgestrel intrauterine system.
调查新西兰妇科医生、全科医生和计划生育医生对月经过多管理指南的实践偏好和态度。
通过邮寄调查问卷收集以下信息：人口统计学信息、实践偏好、对月经过多管理指南的了解、使用情况及态度。该调查问卷被发送给新西兰随机抽取的执业全科医生（n = 531）、所有妇科专科医生（n = 194）以及所有计划生育协会医生（n = 69）。共收到441份回复（56%）。
全科医生和计划生育医生管理月经过多首选的药物是非甾体类抗炎药（23%）。氨甲环酸是专科医生管理月经过多首选的药物（57%），是全科医生和计划生育医生的第二选择（与左炔诺孕酮宫内节育系统并列）（34%）。全科医生和计划生育医生提出的实施该指南的障碍包括无法进行超声检查和获得专科服务，以及氨甲环酸和左炔诺孕酮宫内节育系统缺乏补贴。
自1995年以来，新西兰的专科医生、全科医生和计划生育医生根据月经过多管理指南改变了处方模式。进一步减少障碍应着重于增加超声检查的可及性、专科服务以及对左炔诺孕酮宫内节育系统进行补贴。
