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V Peto

Publications and source records attributed to V Peto.

26 records · Page 2Linked to original sources
PubMed1995

Gynaecology: the experience of patients referred to NHS and private clinics.

This cohort study compared the experience of patients seeking treatment for menorrhagia who were referred to National Health Service (NHS) or private clinics. Two-hundred and nine patients in 73 general practices in Berkshire, Buckinghamshire, Northamptonshire and Oxfordshire were recruited by their general practitioners and followed-up with questionnaires at nine months and 18 months after entry to the study. One hundred and fifty patients were referred to NHS clinics and 59 to private clinics; there were no significant differences between the two groups of patients in terms of symptom severity, reason for referral or treatment received. Patients who went to private clinics were more likely to report active participation in decisions about their care (p < 0.05 after adjustment for age and educational status), and were slightly more likely to be satisfied with the care they had received. The treatment decisions made in gynaecological clinics in the NHS and private sector were similar, but the decision-making styles appeared to be different. Private patients were more likely to participate in treatment decisions than NHS patients.

Adult↗
PubMed1995

Influence of sex of general practitioner on management of menorrhagia.

BACKGROUND: There is an assumption that men and women general practitioners adopt different practice styles in the management of gynaecological disorders. However, there is little evidence to support this view. AIM: A study was undertaken to compare the practice styles of men and women general practitioners in the management of menorrhagia. METHOD: The study took place in 73 general practices in the Oxford Regional Health Authority area. A total of 348 patients who consulted 74 men general practitioners and 43 women general practitioners with a complaint of menorrhagia were recruited into the study and completed postal questionnaires nine and 18 months after entry into the study. Main outcome measures were men and women general practitioners' awareness of patients' treatment preferences, treatment received by patients, patients' involvement in treatment decisions and patients' satisfaction with treatment received. RESULTS: There were no statistically significant differences in treatment received by patients of men and women general practitioners. Fewer patients consulting women general practitioners were referred to a gynaecologist compared with patients consulting men general practitioners (56% versus 64%) and fewer underwent surgery (39% versus 47%). More patients consulting women general practitioners reported participation in treatment decisions (63% versus 53%) but more patients consulting men general practitioners were satisfied with the care they received (66% versus 55%). Again, these differences were not statistically significant. CONCLUSION: Although some indications of sex-associated differences in practice style were found in this study, the similarities in practice styles of men and women general practitioners were more striking than the differences.

Adult↗
PubMed1994

Measuring change over time: a comparison of results from a global single item of health status and the multi-dimensional SF-36 health status survey questionnaire in patients presenting with menorrhagia.

This paper compares the sensitivity to change of a multi-item, multi-dimensional health status measure with a single global health status question, in the assessment of treatment for menorrhagia. A cohort study of patients recruited by general practitioners, was carried out, with a follow up at eighteen months. Questionnaires were administered postally at base-line and follow up. General practices in Berkshire, Buckinghamshire, Northamptonshire and Oxfordshire supplied three hundred and nine women who reported heavy menstrual bleeding, and received either drug treatment alone or both drug and surgical treatment (endometrial resection or hysterectomy) during the eighteen months between the two administrations of the questionnaires. A single global question was given to patients asking them to rate their overall health status as 'excellent', 'very good', 'good', 'fair' or 'poor'. The eight dimensions of the SF-36 health survey questionnaire were also given to patients to complete. The dimensions of the SF-36 indicated only small levels of improvement for patients who received drug treatment. However, on many dimensions of the SF-36, a moderate to large improvement was detected for the surgical group. However, small changes were reported in overall health status, as indicated by the single global question, for both groups. Single item measures of health status may not provide a sufficiently accurate indication of health status to be appropriate for use in longitudinal studies.

Adult↗
PubMed1994

Patients' preferences and general practitioners' decisions in the treatment of menstrual disorders.

The aim of this study was to investigate the treatment preferences of patients consulting their general practitioners (GPs) for heavy menstrual bleeding and the influence of these preferences and other factors on GPs' management decisions. One-hundred and twenty-nine GPs recruited 483 eligible patients into the study, of whom 425 (88.0%) returned completed questionnaires. 35.6% of patients indicated that they had a strong treatment preference. Logistic regression analysis revealed that the strongest independent predictors of the likelihood of having a treatment preference were higher education and previous consultations for gynaecological problems. Among those who expressed a preference for either drug therapy or surgery, those with severe symptoms and those who had not received higher education were more likely to prefer surgical treatment. The likelihood of referral was related to a preference for surgery, as expressed by the patient and as perceived by the GP. Patients were much more likely to be referred to a gynaecologist if they had a history of prior surgery (odds ratio 3.21) and if their GP was male (odds ratio 1.76).

Adult↗
PubMed1994

Quality of life and patient satisfaction following treatment for menorrhagia.

This prospective cohort study of patients who consulted general practitioners complaining of excessive menstrual bleeding measured changes in quality of life and patients' satisfaction following different forms of treatment for menorrhagia. Three hundred and forty-eight patients were followed-up for 18 months using self-completion questionnaires which included generic measurements of health-related quality of life (SF-36) and a disease-specific questionnaire to measure the social impact of menstrual symptoms. Only 15 patients (4%) received no active treatment, 132 (38%) underwent surgical treatment (hysterectomy or endometrial resection), and the remainder were prescribed drugs. Those in the surgical group with both moderate and severe symptoms experienced significant improvements in their quality of life. Patients with moderate symptoms who did not undergo surgery improved in the social functioning and energy dimensions of the SF-36, but those with severe symptoms who received drug treatment only experienced no significant quality-of-life benefits. Patients who had not had surgery were significantly more likely to be dissatisfied with their treatment (21%) than those in the surgical group (5%). Since menorrhagia can have adverse effects on many aspects of a patient's daily life, it is important to measure the effects of treatment on quality of life. This study has demonstrated the feasibility of doing so.

Activities of Daily Living↗
PubMed1993

Factors affecting general practitioners' recruitment of patients into a prospective study.

Many research projects depend on general practitioners (GPs) to recruit patients into the study. As part of a study of patients' experiences of treatment for menorrhagia, completeness of recruitment and the extent of bias introduced by failure to recruit was assessed. Only 129 (41%) of 315 GPs who had agreed to recruit patients actually did so. A review of notes in six practices revealed that only 40 (20.4%) of 196 eligible patients had been recruited. There was some evidence that the recruited patients had more severe symptoms than those not recruited. There was no difference in recruitment rates between male and female doctors, but those who had received a practice visit from a member of the research team recruited more patients. A survey of participating GPs revealed that forgetfulness and time pressures were the main factors inhibiting recruitment.

Adult↗