An international expert panel including both patients and medical professionals has selected a set of key recommendations that should be taken into account to improve the quality of endometriosis care.
The study, “Selection of key recommendations for the management of women with endometriosis by an international panel of patients and professionals,” was published in the journal Human Reproduction.
Endometriosis is one of the most common gynecological disorders, affecting 2 to 10 percent of women worldwide. It is characterized by the presence of endometrial tissue outside the uterus, leading to infertility and pain, as well as social and psychological negative effects in affected women. Currently, there is no cure for endometriosis and available treatments intend to improve fertility and reduce endometriosis-associated pain. However, due to the wide variety of clinical practice, a large number of patients receive delayed or sub-optimal treatment.
In 2014, the European Society of Human Reproduction and Embryology (ESHRE) developed guidelines for the “Management of Women with Endometriosis,” aiming to improve European endometriosis care. Nonetheless, guideline adherence faced a number of barriers, either patient-related, physician-related, guideline-related or organizational barriers, hindering healthcare improvement. Therefore, quality indicators that monitor guideline adherence and actual care are needed to help better implement ESHRE’s guidelines.
Researchers selected a panel of international endometriosis experts, including ten patients and 11 medical professionals that evaluated the ESHRE guidelines and prioritized its 83 recommendations in three different rounds. A representative set of 17 key recommendations that covered different dimensions of endometriosis care, such as diagnosis, treatment of endometriosis-associated pain and infertility, prevention, and relationship with cancer, were selected.
The feasibility of the selected key recommendations was not assessed in this study because not all panel members took part in all three rounds of selection. Still, the creation of this set of key recommendations, which is generic and can be used in hospitals internationally, is the first step to develop quality indicators for monitoring and improving endometriosis care.
“A key strength of this study is the combination of evidence and expert opinion, involving both patients and medical professionals from nine different countries,” researchers wrote in their study. However, they suggest a pilot study in one or two hospitals to establish the applicability and measurability of their set of key recommendations.