QS ENDO Real - A Study by the German Endometriosis Research Foundation (SEF) on the Reality of Care for Patients with Endometriosis in Germany, Austria and Switzerland.

care research endometriosis quality assurance quality of care

Journal

Geburtshilfe und Frauenheilkunde
ISSN: 0016-5751
Titre abrégé: Geburtshilfe Frauenheilkd
Pays: Germany
ID NLM: 0370732

Informations de publication

Date de publication:
Feb 2020
Historique:
received: 13 02 2019
revised: 20 09 2019
accepted: 23 11 2019
entrez: 29 2 2020
pubmed: 29 2 2020
medline: 29 2 2020
Statut: ppublish

Résumé

Endometriosis affects a significant number of young premenopausal women. Quite apart from the medical challenges, endometriosis is a relevant burden for healthcare and social security systems. Standardized quality indicators for the treatment of endometriosis have not previously been systematically verified. The three-stage study QS ENDO was initiated to record and improve the reality and quality of care. One of its aims is to create quality indicators for the diagnosis and treatment of endometriosis. For the first stage of QS ENDO Real, letters were sent to all 1014 gynecological departments in the German-speaking area of Europe (the DACH region) which included a questionnaire as a means of surveying the current state of care. A total of 296 (29.2%) of the centers which received the questionnaire participated in the survey. The subsequent evaluation of the completed questionnaires showed that the majority of patients with endometriosis (around 60%, based on estimates from the data) are not treated in hospitals which have been certified by the SEF. The guidelines recommend the use of specific classification systems (rASRM, ENZIAN) but, depending on the level of care offered by the hospital, only around 44.4 to 66.4% of departments used the rASRM score and only 27% of hospitals used the ENZIAN classification system to describe deep-infiltrating endometriosis. When taking patients' medical history, some centers (6.6 - 17.9%) considered questions about leading symptoms such as dyschezia, dysuria and dyspareunia to be unimportant. QS ENDO Real has made it possible, for the first time, to get an overview of the reality of care provided to patients with endometriosis in the German-speaking areas of Europe. The findings indicate that several of the measures recommended in international guidelines as the gold standard of care are only used to treat some of the patients. In this respect, more efforts will be needed to provide more advanced training. The approach used for treatment must be guideline-based, also in not-certified centers, to improve the quality of care in the treatment of patients with endometriosis.

Identifiants

pubmed: 32109970
doi: 10.1055/a-1068-9260
pii: 10689260
pmc: PMC7035138
doi:

Types de publication

Journal Article

Langues

eng

Pagination

179-189

Déclaration de conflit d'intérêts

Conflict of Interest/Interessenkonflikt No conflicts of interest reported. Several authors are leaders of SEF-certified Endometriosis centers. Klaus Bühler, Karl-Werner Schweppe and Martin Sillem are members of the SEF board./Kein Interessenkonflikt angegeben. Einige der Autoren sind Leiter SEF-zertifizierter Endometriosezentren. Klaus Bühler, Karl-Werner Schweppe und Martin Sillem sind Mitglieder des SEF-Vorstandes.

Références

J Minim Invasive Gynecol. 2011 Jul-Aug;18(4):483-8
pubmed: 21777838
Geburtshilfe Frauenheilkd. 2016 Feb;76(2):176-181
pubmed: 26941451
Hum Reprod. 2013 Oct;28(10):2677-85
pubmed: 23847114
Geburtshilfe Frauenheilkd. 2014 Dec;74(12):1104-1118
pubmed: 26157194
Fertil Steril. 1997 May;67(5):817-21
pubmed: 9130884
Geburtshilfe Frauenheilkd. 2018 Oct;78(10):984-990
pubmed: 30364331
Fertil Steril. 2011 Aug;96(2):366-373.e8
pubmed: 21718982
Hum Reprod. 2012 Dec;27(12):3412-6
pubmed: 22990516
Geburtshilfe Frauenheilkd. 2019 May;79(5):487-497
pubmed: 31148849
Zentralbl Gynakol. 2005 Oct;127(5):275-81
pubmed: 16195969
Zentralbl Gynakol. 2005 Feb;127(1):18-30
pubmed: 15702447
Gynecol Obstet Invest. 2016;81(4):321-4
pubmed: 26742108
Fertil Steril. 2012 Sep;98(3):511-9
pubmed: 22819144
Lancet Oncol. 2012 Apr;13(4):385-94
pubmed: 22361336
N Engl J Med. 2017 May 11;376(19):1835-1848
pubmed: 28489996
Geburtshilfe Frauenheilkd. 2016 Aug;76(8):875-881
pubmed: 27582581
J Clin Oncol. 1997 Nov;15(11):3408-15
pubmed: 9363873
Zentralbl Gynakol. 2005 Feb;127(1):9-17
pubmed: 15702446
J Psychosom Obstet Gynaecol. 2015;36(4):135-41
pubmed: 26328618
Hum Reprod. 2012 May;27(5):1292-9
pubmed: 22422778
Obstet Gynecol. 2016 Jun;127(6):1045-53
pubmed: 27159755
Biomed Res Int. 2015;2015:751571
pubmed: 26413541
Acta Obstet Gynecol Scand. 2011 Oct;90(10):1164-6
pubmed: 21668417

Auteurs

Felix Zeppernick (F)

UKGM, Zentrum für Frauenheilkunde Gießen, Gießen, Germany.

Magdalena Zeppernick (M)

UKGM, Zentrum für Frauenheilkunde Gießen, Gießen, Germany.

Elisabeth Janschek (E)

LKH Villach, Villach, Austria.

Monika Wölfler (M)

Frauenklinik der medizinischen Universität Graz, Graz, Austria.

Sebastian Bornemann (S)

MMF GmbH, Dortmund, Germany.

Laura Holtmann (L)

MMF GmbH, Dortmund, Germany.

Frank Oehmke (F)

UKGM, Zentrum für Frauenheilkunde Gießen, Gießen, Germany.

Iris Brandes (I)

Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover, Hannover, Germany.

Chi Mi Scheible (CM)

Johanniter GmbH; Evangelisches Krankenhaus Bethesda Mönchengladbach, Mönchengladbach, Germany.

Darius Salehin (D)

Johanniter GmbH; Evangelisches Krankenhaus Bethesda Mönchengladbach, Mönchengladbach, Germany.

Sigrid Vingerhagen Pethick (SV)

Drammen Hospital, Drammen, Norway.

Alexander Stephan Boosz (AS)

Städtisches Klinikum Karlsruhe, Karlsruhe, Germany.

Bernhard Krämer (B)

Universitätsfrauenklinik Tübingen, Tübingen, Germany.

Martin Sillem (M)

Vorstand Stiftung Endometriose-Forschung, Germany.
Praxisklinik am Rosengarten, Mannheim, Germany.

Klaus Bühler (K)

klin.-wissenschaftl. Endometriosezentrum der Univ.-Kliniken des Saarlandes, Frauenärzte am Staden, Saarbrücken, Germany.
Klinik für Frauenheilkunde und Fortpflanzungsmedizin Universitätsklinikum Jena, Jena, Germany.

Jörg Keckstein (J)

Vorstand Stiftung Endometriose-Forschung, Germany.

Karl Werner Schweppe (KW)

Vorstand Stiftung Endometriose-Forschung, Germany.

Ivo Meinhold-Heerlein (I)

UKGM, Zentrum für Frauenheilkunde Gießen, Gießen, Germany.

Classifications MeSH