Les freins et leviers au diagnostic et à la prise en charge des femmes atteintes d’endométriose en soins de santé primaires : étude qualitative auprès des médecins généralistes

Introduction: endometriosis is a chronical gynecological pathology affecting almost one in ten women. It materializes through the presence of ectopic endometrial cells. Responsible for alteration in the quality of life, this pathology results in a chaotic diagnosis process, leading to a deterioration of the lesions, and huge healthcare expenses. Primary cares providers are the patient’s first point of contact, hence the focus on general practitioners (GP) in this study. Objectives: to describe obstacles and levers to the diagnosis and support of women with endometriosis by general practitioners. To propose recommendations to improve the overall care of the patient. Material and method: qualitative study using semi-directed interviews with general practitioners. Results: 14 GPs were interviewed between June 2021 and April 2022, either face-to-face, by phone or video conference. The main obstacles identified were GPs' lack of knowledge on the subject and lack of time in consultations. The denial of the disease by doctors was described in half of the interviews. The main lever identified was the trust established with the patient, thanks to the doctor's listening and empathetic attitude. Conclusion: our results highlighted the obstacles to the diagnosis of the disease related to the doctor, the patient, but also to the disease itself. We have come up with proposals for recommendations such as improving training, optimising exchanges with specialists, and creating a specific rating for this complex pathology. This study underlines the importance of the doctor/patient relationship based on listening and empathy.