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 menstr ual bleeding and the influence of these preferences and other factors on GPs' management decisions. One-hundred and twenty-nine GPs recruite d 483 eligible patients into the study, of whom 425 (88.0%) returned c ompleted questionnaires. 35.6% of patients indicated that they had a s trong treatment preference. Logistic regression analysis revealed that the strongest independent predictors of the likelihood of having a tr eatment preference were higher education and previous consultations fo r gynaecological problems. Among those who expressed a preference for either drug therapy or surgery, those with severe symptoms and those w ho had not received higher education were more likely to prefer surgic al treatment. The likelihood of referral was related to a preference f or surgery, as expressed by the patient and as perceived by the GP. Pa tients 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).