Abstract:
Whilst professional bodies such as the Royal College and the American College of Obstetricians and Gynecologists have well-established standards for audit of management for most gynaecology disorders, such standards for premenstrual disorders (PMDs) have yet to be developed. The International Society of Premenstrual Disorders (ISPMD) has already published three consensus papers on PMDs covering areas that include definition, classification/quantification, clinical trial design and management (American College Obstetricians and Gynecologists 2011; Brown et al. in Cochrane Database Syst Rev 2:CD001396, 2009; Dickerson et al. in Am Fam Physician 67(8):1743-1752, 2003). In this fourth consensus of ISPMD, we aim to create a set of auditable standards for the clinical management of PMDs. All members of the original ISPMD consensus group were invited to submit one or more auditable standards to be eligible in the inclusion of the consensus. Ninety-five percent of members (18/19) responded with at least one auditable standard. A total of 66 auditable standards were received, which were returned to all group members who then ranked the standards in order of priority, before the results were collated. Proposed standards related to the diagnosis of PMDs identified the importance of obtaining an accurate history, that a symptom diary should be kept for 2 months prior to diagnosis and that symptom reporting demonstrates symptoms in the premenstrual phase of the menstrual cycle and relieved by menstruation. Regarding treatment, the most important standards were the use of selective serotonin reuptake inhibitors (SSRIs) as a first line treatment, an evidence-based approach to treatment and that SSRI side effects are properly explained to patients. A set of comprehensive standards to be used in the diagnosis and treatment of PMD has been established, for which PMD management can be audited against for standardised and improved care.
摘要:
虽然皇家学院和美国妇产科学院等专业机构对大多数妇科疾病的管理审计都有完善的标准,这种经前紊乱(PMDs)的标准尚未制定。国际经前疾病学会(ISPMD)已经发表了三篇关于PMD的共识论文,涵盖了包括定义,分类/量化,临床试验设计和管理(美国大学妇产科医生2011;Brown等人。在Cochrane数据库系统修订版2:CD001396,2009;Dickerson等人。AmFam医师67(8):1743-1752,2003)。在ISPMD的第四个共识中,我们的目标是为PMD的临床管理创建一套可审计的标准.邀请原始ISPMD共识小组的所有成员提交一个或多个可审计标准,以符合纳入共识的条件。95%的成员(18/19)回答了至少一个可审计的标准。共收到66项可审计标准,返回给所有小组成员,然后按优先顺序对标准进行排名,在整理结果之前。与PMD诊断相关的拟议标准确定了获得准确病史的重要性。症状日记应在诊断前保存2个月,症状报告表明症状在月经周期的经前阶段并因月经而缓解。关于治疗,最重要的标准是使用选择性5-羟色胺再摄取抑制剂(SSRIs)作为一线治疗,以证据为基础的治疗方法和SSRI副作用向患者正确解释。已经建立了一套用于PMD诊断和治疗的综合标准,可以对PMD管理进行审核,以实现标准化和改进护理。