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Unmet treatment needs in patients with chronic pelvic pain in a New Zealand gynaecology service
Author(s) -
Joseph Karen,
Mills Jessica
Publication year - 2019
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.13059
Subject(s) - medicine , psychosocial , referral , pelvic pain , physical therapy , outpatient clinic , distress , chronic pain , specialty , triage , family medicine , emergency medicine , surgery , psychiatry , clinical psychology
Background Chronic pelvic pain, which carries a high burden of disability and distress, is a common presentation to gynaecology clinics. While there is increasing acknowledgment of the complexity of chronic pelvic pain, and the benefits of providing management from a multidisciplinary team within a sociopsychobiomedical framework, the mainstay of management in gynaecology outpatient clinics remains within a single clinician biomedical‐focused model. This model of care is only sufficient for women who present with minimal psychosocial complexity to their pain. Aims To estimate the proportion of women attending the gynaecology outpatient clinic at a public women's hospital in New Zealand referred with chronic pelvic pain who have needs unmet by the current biomedical model of care. Informed by international research, pain catastrophising was used as a psychosocial correlate of this complexity. Methods An audit was undertaken of 100 consecutive pre‐appointment questionnaires of women, referred to a gynaecology outpatient clinic for review of pelvic pain of duration over six months, with no red flags in their referral history. Results An unexpectedly high level of catastrophic thoughts about pain was reported. Seventy‐seven percent of the women scored in the high or severe range, with 55% endorsing clinically significant scores for helpless catastrophising .Conclusions The Pain Catastrophising Scores in this cohort were found to be higher than those in similar groups in the published international literature and also than in patients referred to the local tertiary level pain management centre, further reinforcing the need for investment into appropriate services for women with chronic pelvic pain.