Randomised trial of an integrated educational strategy to reduce investigation rates in young women with dysfunctional uterine bleeding

Judith Searle, Sonia Grover, Anita Santin, Prue C. Weideman, Prue Weideman
The Australian & New Zealand journal of obstetrics & gynaecology · 2002 · vol. 42(4) , pp. 397–402 · doi:10.1111/j.0004-8666.2002.00397.x · PMID:12403289 · W2016184074
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An educational intervention improved evidence-based behavior among clinicians but did not reduce hysteroscopy or D&C rates for young women with dysfunctional uterine bleeding after six months.

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Abstract

OBJECTIVES: To assess the effectiveness of an integrated educational strategy to change clinician behaviour and reduce the number of hysteroscopies and/or dilatation and curettages for women 40 years or less with dysfunctional uterine bleeding (DUB). DESIGN: Randomised controlled trial with six-month follow-up. SETTING: Public teaching hospital gynaecology units with 12,000-13,000 relevant procedures per year. PARTICIPANTS: Six public gynaecology units made up of 62 gynaecologists or trainees allocated at random to intervention group - three, or control group - 3. Intervention An educational strategy that included dissemination of evidence-based guidelines via a problem-based interactive workshop facilitated by an opinion leader and a laminated algorithm and guidelines. MAIN OUTCOME MEASURES: The number of hysteroscopies and/or dilatation and curettages performed for DUB on women 40 years or less, clinician behaviour change and perceived booking rates of the procedure. RESULTS: At six months, there was no significant effect on the number of hysteroscopies and/or dilatation and curettages performed but there was an increase in evidence-based behaviour. CONCLUSIONS: While the evidence-based educational strategy for the appropriate investigation of young women with DUB resulted in clinician behaviour change when applied to theoretical cases, it did not result in a reduction in hysteroscopy/D&C rates at six months.

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MeSH descriptors

Curettage Education, Medical, Continuing Gynecology Hysteroscopy Practice Patterns, Physicians' Uterine Hemorrhage Adult Curettage Evidence-Based Medicine Female Gynecology Health Services Research Hospitals, Teaching Humans Hysteroscopy Information Dissemination Male Middle Aged Uterine Hemorrhage Victoria

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