A survey of practice preferences and attitudes to the New Zealand Guidelines for the Management of Heavy Menstrual Bleeding

OBJECTIVE: To survey the practice preferences and the attitudes of New Zealand gynaecologists, general practitioners and family planning doctors to Guidelines for the Management of Heavy Menstrual Bleeding. STUDY DESIGN: A postal survey collected information on the following: demographics, practice preferences, knowledge of, usage of and attitudes toward the Guidelines for the Management of Heavy Menstrual Bleeding. The survey was sent to randomly selected practising general practitioners (n = 531), all specialist gynaecologists (n = 194) and all Family Planning Association doctors (n = 69) in New Zealand. Replies were received from 441 (56%). RESULTS: The preferred first choice for the management of heavy menstrual bleeding by general practitioners and family planning doctors was nonsteroidal anti-inflammatory medications (23%). Tranexamic acid was the preferred first choice medication for the management of heavy menstrual bleeding by specialists (57%), and preferred second choice (as well as levonorgestrel intrauterine system) by general practitioners and family planning doctors (34%). Barriers identified by general practitioners and family planning doctors to implementing the guideline included inability to access ultrasound scanning and specialist services, and a lack of subsidy for tranexamic acid and the levonorgestrel intrauterine system. CONCLUSIONS: There has been a change in prescribing patterns since 1995 among specialist and general practitioners and family planning doctors in New Zealand in accordance with the Guidelines for the Management of Heavy Menstrual Bleeding. Further attention to reducing barriers should focus on increasing access to ultrasound scanning, specialist services and subsidising the levonorgestrel intrauterine system.