Abstract
Introduction and hypothesis
The physiotherapy-led pelvic health clinic (PLPHC) is an advanced practice clinic that manages women from the urogynaecology waitlist with pelvic organ prolapse (POP) and/or urinary incontinence (UI) at Gold Coast Health, Australia. This study was aimed at determining re-referral rates and reasons for re-presentation of women previously managed and discharged from the PLPHC. We hypothesised that there would be low representation rates for the same condition within 12 months of discharge.
Methods
A retrospective audit was undertaken of all (n = 209) patients discharged between 1 January and 31 December 2017. Re-presentation rates and reasons for re-referral for women seen in the PLPHC and discharged without requiring urogynaecology medical specialist review were analysed and descriptive analysis performed.
Result
Of the 209 patients, 67 were referred to, or had, urogynaecology medical specialist review after their initial physiotherapy care and were removed from further analysis. Of the remaining 142 patients, who were initially managed by physiotherapy only, 10 (7.1%) women were re-referred to specialist medical outpatient gynaecology and urology out-patient departments, for management of a different diagnosis, and 10 (7.1%) for their original diagnoses, within 12 months of discharge. Of the latter, 1 patient required further physiotherapy and urogynaecologist management; 7 patients required ongoing pessary management; 1 patient continued with urologist medical management; and 1 failed to attend.
Conclusion
This study presents novel data on low re-presentation rates in the 12 months following discharge for patients with POP or UI managed in a PLPHC; and provides further support for advanced scope of practice physiotherapy gynaecological service models.
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Change history
06 August 2021
The ORCID links for authors Zara Howard and Kelly A. Weir were inadvertently interchanged. This has been fixed and corrected.
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Acknowledgements
The author would like to acknowledge assistance provided by the Gold Coast Health Urogynaecology team, clinical and administrative staff of the PLPHC, and Health Informatics and Business Analytics services.
Funding
The project received funding from the Gold Coast Health Allied Health Research Clinical Backfill scheme.
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J. Nucifora: research question and design, protocol development, data collection, data analysis and interpretation, manuscript writing; Z. Howard: research question and design, protocol development, data collection, data analysis and interpretation, manuscript editing; K.A. Weir: research question and design, protocol development, data interpretation, manuscript editing, research mentoring.
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Nucifora, J., Howard, Z. & Weir, K.A. Do patients discharged from the physiotherapy-led pelvic health clinic re-present to the urogynaecology service?. Int Urogynecol J 33, 689–695 (2022). https://doi.org/10.1007/s00192-021-04912-w
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DOI: https://doi.org/10.1007/s00192-021-04912-w