Shared research priorities for pessary use in women with prolapse: results from a James Lind Alliance Priority Setting Partnership

Kate Lough, Suzanne Hagen, Doreen McClurg, Alex Pollock, JLA Pessary PSP Steering Group, Kate Lough, Suzanne Hagen, Doreen McClurg, Alex Pollock, JLA Pessary PSP Steering Group

Abstract

Objectives: To identify the shared priorities for future research of women affected by and clinicians involved with pessary use for the management of prolapse.

Design: A priority setting project using a consensus method.

Setting: A James Lind Alliance Pessary use for prolapse Priority Setting Partnership (JLA Pessary PSP) conducted from May 2016 to September 2017 in the UK.

Participants: The PSP was run by a Steering Group of three women with experience of pessary use, three experienced clinicians involved with management of prolapse, two researchers with relevant experience, a JLA adviser and a PSP leader. Two surveys were conducted in 2016 and 2017. The first gathered questions about pessaries, and the second asked respondents to prioritise a list of questions. A final workshop was held on 8 September 2017 involving 10 women and 13 clinician representatives with prolapse and pessary experience.

Results: A top 10 list of priorities for future research in pessary use for prolapse was agreed by consensus.

Conclusions: Women with experience of pessary use and clinicians involved with prolapse management have worked together to determine shared priorities for future research. Aligning the top 10 results with existing research findings will highlight the gaps in current evidence and signpost future research to areas of priority. Effective dissemination of the results will enable research funding bodies to focus on gathering the evidence to answer the questions that matter most to those who will be affected.

Keywords: consensus; health priorities; pelvic organ prolapse; pessaries.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Flow chart of the James Lind Alliance (JLA) Priority Setting Partnership (PSP) process.
Figure 2
Figure 2
James Lind Alliance (JLA) Pessary Priority Setting Partnership (PSP) final workshop flow chart.

References

    1. Hendrix SL, Clark A, Nygaard I, et al. . Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol 2002;186:1160–6. 10.1067/mob.2002.123819
    1. Gyhagen M, Bullarbo M, Nielsen TF, et al. . Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG 2013;120:152–60. 10.1111/1471-0528.12020
    1. Panman CMCR, Wiegersma M, Kollen BJ, et al. . Effectiveness and cost-effectiveness of pessary treatment compared with pelvic floor muscle training in older women with pelvic organ prolapse. Menopause 2016;23:1307–18. 10.1097/GME.0000000000000706
    1. Haylen BT, Maher CF, Barber MD, et al. . An International Urogynecological Association (IUGA) / International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Organ Prolapse (POP). Neurourol Urodyn 2016;35:137–68. 10.1002/nau.22922
    1. Oliver R, Thakar R, Sultan AH. The history and usage of the vaginal pessary: a review. Eur J Obstet Gynecol Reprod Biol 2011;156:125–30. 10.1016/j.ejogrb.2010.12.039
    1. Gorti M, Hudelist G, Simons A. Evaluation of vaginal pessary management: a UK-based survey. J Obstet Gynaecol 2009;29:129–31. 10.1080/01443610902719813
    1. Pott-Grinstein E, Newcomer JR. Gynecologists' patterns of prescribing pessaries. J Reprod Med 2001;46:205–8.
    1. Cundiff GW, Weidner AC, Visco AG, et al. . A survey of pessary use by members of the American urogynecologic society. Obstet Gynecol 2000;95(Pt 1):931–5.
    1. Bugge C, Ej A, Gopinath D, et al. . Pessaries (mechanical devices) for pelvic organ prolapse in women (Review) summary of findings for the main comparison. Cochrane Database Syst Rev 2013.
    1. Cowan K, Oliver S. The James Lind Alliance guidebook. 6th Ed Oxford, England: James Lind Alliance, 2016.
    1. Lough K. A systematic review of the use of pessaries for the management of pelvic organ prolapse in women [Internet]. PROSPERO CRD42016046793. 2016;3:1 .
    1. Cheung RYK, Lee JHS, Lee LL, et al. . Vaginal pessary in women with symptomatic pelvic organ prolapse. Obstetrics & Gynecology 2016;128:73–80. 10.1097/AOG.0000000000001489
    1. Taege SK, Adams W, Mueller ER, et al. . Anesthetic cream use during office pessary removal and replacement. Obstetrics & Gynecology 2017;130:190–7. 10.1097/AOG.0000000000002098
    1. Meriwether KV, Komesu YM, Craig E, et al. . Sexual function and pessary management among women using a pessary for pelvic floor disorders. J Sex Med 2015;12:2339–49. 10.1111/jsm.13060
    1. Cundiff GW, Amundsen CL, Bent AE, et al. . The PESSRI study: symptom relief outcomes of a randomized crossover trial of the ring and Gellhorn pessaries. Am J Obstet Gynecol 2007;196:405.e1–405.e8. 10.1016/j.ajog.2007.02.018
    1. Brazell HD, O’Sullivan DM, Forrest A, et al. . Effect of a decision aid on decision making for the treatment of pelvic organ prolapse. Female Pelvic Med Reconstr Surg 2015;21:231–5. 10.1097/SPV.0000000000000149

Source: PubMed

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