Should endometriosis be managed within a chronic disease framework? An analysis of national policy documents

Rebecca O Hara, O Hara R, Rebecca O’Hara, Rowe H, Heather Rowe, Louise Roufeil, Roufeil L, Jane Fisher, Fisher J
Australian health review : a publication of the Australian Hospital Association · 2018 · vol. 42(6) , pp. 627–634 · doi:10.1071/ah17185 · PMID:30092169 · W2886117107
article OA: hybrid CC0 ⤵ 7 in-corpus citations
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This study analyzed Australian policy documents and found that endometriosis shares most key characteristics of a chronic disease, suggesting it could be managed within existing chronic disease frameworks like management plans.

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Abstract

Objective The aim of this study was to determine whether endometriosis meets the definition for chronic disease in Australian policy documents. Methods A qualitative case study approach was used to thematically analyse the definitions contained in Australian chronic disease policy documents and technical reports. The key themes were then compared with descriptions of endometriosis in peer-reviewed literature, clinical practice guidelines and expert consensus statements. Results The search yielded 18 chronic disease documents that provided a definition or characteristics of chronic disease. The thematic analysis identified key elements of chronic diseases pertaining to onset, causation, duration, treatment, disease course and impact (individual and societal). A comparison with endometriosis descriptions indicated that endometriosis meets five of the six chronic disease key elements. Conclusion In Australia, long-term and complex conditions are managed within a chronic disease framework and include mechanisms such as chronic disease management plans (CDMPs) to assist with coordination and management of these conditions. Because endometriosis has most of the characteristics of chronic disease, it could potentially be reframed as a chronic disease in endometriosis clinical practice guidelines and consensus statements. Further, the use of CDMPs may provide a mechanism to promote individualised care and multidisciplinary management of this chronic, enigmatic and debilitating disease. What is known about the topic? In Australia, long-term complex diseases can be managed within a chronic disease framework that include mechanisms for coordinated care such as CDMPs and team care arrangements. Endometriosis is described as an inflammatory, progressive, relapsing and, for some women, debilitating condition, but is rarely described as a chronic disease in the clinical practice guidelines and consensus statements available in Australia. What does this paper add? Endometriosis shares most of the characteristics of a chronic disease so may benefit from chronic disease management systems such as CDMPs. What are the implications for practitioners? CDMPs may be a useful mechanism to coordinate and improve the effectiveness of care for women with endometriosis who experience sustained symptoms of endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Chronic Disease Endometriosis Health Policy Australia Chronic Disease Consensus Statements as Topic Endometriosis Female Humans Practice Guidelines as Topic

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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