PT  - JOURNAL ARTICLE
AU  - Rohna Kearney
AU  - Claire Brown
TI  - Self-management of vaginal pessaries for pelvic organ prolapse
AID  - 10.1136/bmjquality.u206180.w2533
DP  - 2014 Jan 01
TA  - BMJ Quality Improvement Reports
PG  - u206180.w2533
VI  - 3
IP  - 1
4099  - http://bmjopenquality.bmj.com/content/3/1/u206180.w2533.short
4100  - http://bmjopenquality.bmj.com/content/3/1/u206180.w2533.full
SO  - BMJ Qual Improv Report2014 Jan 01; 3
AB  - Two thirds of women opt to use a vaginal pessary initially to manage the symptoms of pelvic organ prolapse. In the UK most women attend a health care professional at least every six months to change the pessary. This represents a significant burden both economically to the health care system and personally for the woman. Annually there are more than 300 appointments for pessary changes at our hospital. We developed a programme to teach women to self-manage their pessaries with the aim of improving patient experience and reducing outpatient attendances to free up outpatient capacity for new referrals. A physiotherapist was recuited to deliver this programme involving a one to one training session supplemented with written materials and an online video. Women using pessaries were offered the option of self-management. Eighty-eight women aged between 29 to 84 years enrolled in the programme. Sixty-three women (73% of those enrolled) successfully continued with self-management at six months, creating 126 extra outpatient appointment capacity in one year alone. Women self-managing reported higher levels of convenience (94% vs 81%), accessibility (97% vs 73%), support (100% vs. 83%), and comfort (86% vs. 53%) than those attending the hospital for GP practice for pessary change. Self-management appears to be an acceptable option for many women using vaginal pessaries, with personal benefits to the women and economic benefits to the hospital and commissioners.