The Effect of a Physician Consultation on Patient Reported Outcomes in Urogynecology

Emily Edwards, Sarah Boyles, Claire Gould, Blake Osmundsen
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Abstract

Importance It has not yet been determined whether there is an effect of the initial urogynecologic consultation and resultant management plan on the patient’s bother from her pelvic floor condition. Objective The aim of the study was to see whether patient-reported outcomes of bother were different before and after consultation with a specialist. Study Design Fifty patients completed both preconsultation and postconsultation Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7). Patients were eligible if they were naive to urogynecology care and had never had treatment for the chief complaint in the past. They were not eligible if they received treatment at their consultation visits. A paired t test was used for comparison. A linear model determined whether baseline PFDI-20 and PFIQ-7 scores as explanatory variables had an effect on the pre-post delta as outcome variable. Results There was no statistically significant difference between PFDI-20 scores before (mean, 86.5) and after (mean, 83.1) consultation. There was additionally no difference between PFIQ-7 scores before (mean, 61.1) and after (mean, 65.4) consultation. There was, however, a greater degree of change in scores if the patient presented with little bother versus large bother at the initial consultation. Conclusions For the new urogynecologic patients, those with lower baseline bother showed higher change (improvement) in scores after the consultation.
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医生会诊对泌尿妇科患者报告结果的影响
重要性 首次泌尿妇科会诊及会诊后的治疗方案是否会对患者盆底状况造成的困扰产生影响,目前尚未确定。本研究旨在了解患者报告的困扰结果在接受专家会诊前后是否有所不同。研究设计 50 名患者完成了咨询前和咨询后盆底压力量表 (PFDI-20) 和盆底影响问卷 (PFIQ-7)。如果患者对泌尿妇科护理一无所知,且过去从未因主诉接受过治疗,则符合条件。如果患者在就诊时接受过治疗,则不符合条件。采用配对 t 检验进行比较。通过线性模型确定作为解释变量的 PFDI-20 和 PFIQ-7 基线分数是否会对作为结果变量的前后 delta 产生影响。结果 咨询前(平均 86.5 分)和咨询后(平均 83.1 分)的 PFDI-20 分数在统计学上没有显著差异。此外,PFIQ-7 评分在咨询前(平均值为 61.1)和咨询后(平均值为 65.4)之间也没有差异。不过,如果患者在初诊时表现为 "小烦恼",那么得分的变化程度要大于 "大烦恼"。结论 对于新的泌尿妇科疾病患者,基线困扰较低的患者在就诊后的评分变化(改善)较高。
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Staged Versus Concomitant Stress Incontinence Procedures With Prolapse Repairs The Effect of a Physician Consultation on Patient Reported Outcomes in Urogynecology 16th EUGA Annual Congress 19-21 October 2023, Varese – Palais des Congrès Laser and Pelvic Floor Muscle Training for Urinary Incontinence: A Randomized Clinical Trial. Access to Urogynecologic Care in Federally Qualified Health Centers: A Mystery Caller Study.
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