Frías Vargas M, Fontanillas Gamilla N, Rivera Panizo I, Fuertes Domínguez D, Granja Ortega C, Peiró Morant J F
Centro de Salud San Andrés, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España.
Centro de Salud Bezana, Santa Cruz de Bezana, Cantabria, España.
Semergen. 2025 Apr;51(3):102393. doi: 10.1016/j.semerg.2024.102393. Epub 2024 Dec 10.
Hemorrhoidal disease (HD) is a public health problem in our clinics and in the quality of life of patients, therefore it is necessary to analyze the actions in the management of HD by healthcare professionals in Spain.
Observational, descriptive and cross-sectional study with data collection through a 28-question survey using a Google® form. 240 surveys were received. Quantitative variables were represented with means and standard deviation and qualitative variables with percentages.
Two hundred and forty surveys were analyzed. Sixty-five percent of respondents were women, with a mean age of 48±12years. Ninety-three percent of the professionals had 21-30years of clinical experience, with more than 70% being family physicians. Fifty-nine percent considered that HD is adequately diagnosed in primary care, but there was a negative impact on follow-up during the COVID-19 pandemic, as 90% considered it inadequate. Forty-two percent of participants were not familiar with the Goligher classification, while 20% knew it and used it in their practice. The most commonly prescribed combination was the use of topical corticosteroids, bulk-forming laxatives, phlebotonics or venoactive drugs, and non-pharmacological measures (12.1%), with diosmin/hesperidin being the most prescribed venoactive agent (63%). Thirty-nine point six percent stated that HD is undertreated. Eighty-nine percent of physicians acknowledged not using any algorithm or protocol for the diagnosis, treatment, and follow-up of HD in their practice, and 89% stated that they were not trained in their workplaces. Seventy-five percent of doctors believed that one of the main limitations hindering the follow-up of the disease was the lack of time during consultations.
Approximately 3 out of 5 professionals believe they adequately manage HD, and only 1 out of 5 respondents acknowledge knowing and using the Goligher classification in their clinical practice. Furthermore, 2 out of 5 assert that HD is undertreated in primary care. The prescription patterns for HD are heterogeneous, involving multiple combinations. The vast majority of professionals do not follow any established protocol for managing the disease. The survey highlights the need for training our professionals in the diagnosis, treatment, and follow-up of HD to ensure that our patients receive the highest possible quality of healthcare.
