Page 80 - Diagnostic delay of endometriosis

“Well I think I refer migrants easily, because I find the conversation more difficult. Communication about pain, how to handle it or how to address it. I somatise more easily, faster referral. They always present their symptoms more dramatically as well, and maybe they value diagnostic tests more than others. “ [FG4, GP3, male]
Guideline factors
The lack of a national guideline for GPs concerning endometriosis or abdominal pain was mentioned in five out of six focus groups. The participants suggested a clinical guideline, written in their own language and developed by and for both GPs and gynaecologists. This joint guideline should ideally provide the GPs with a summary of the most recent relevant literature as well as clear instructions about which therapy they can start themselves, when referral is advised and which actions may be undertaken by the gynaecologists.
“GP1: One thing I do miss is the fact that none of our GP guidelines mention endometriosis. GP2: While apparently it has a high prevalence... GP1: Exactly. ” [FG3, GP1, female and GP2, female]
“Maybe a joint guideline would help. So you will have something to pull up when you think of it. It would provide you with considerations and advice regarding diagnostics and treatment. “ [FG3, GP6, male]and advice regarding diagnostics and treatment. “ [FG3, GP6, male]
Collaboration
The GPs unanimously preferred more collaboration with gynaecologists about indications and instructions for empirical or first-line treatment and timing of referral. In all six focus groups, the GPs stated that they were reluctant in referring patients for further diagnostic testing on endometriosis. They questioned the added value of establishing a definite diagnosis and fear the inappropriate use of invasive techniques, since the treatment regimens appeared the same to them whether the diagnosis was confirmed or not. The participants suggested that improvements in the quality of correspondence after a woman is referred may increase awareness of endometriosis and motivation for early referral. They stated that reporting on considerations about endometriosis by the gynaecologists may help in a better understanding and motivates them to consider endometriosis more easily in future consultations. Besides this, they advised gynaecologists and
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