This clinical audit investigated how many women with heavy menstrual bleeding were offered a levonorgestrel intrauterine system (LNG-IUS) prior to hysterectomy at Middlemore Hospital in South Auckland, over a 12-month period (from 30 April 2014 to 1 May 2015). Of the 81 patients who met the study inclusion criteria, 63 (78%) were offered and 18 (22%) were not offered the LNG-IUS before proceeding to a hysterectomy. Of the 63 patients who were offered the LNG-IUS, 11 (18%) refused the treatment.
Evidence from the US suggests that ethnic disparities occur between African Americans and Whites for all surgical procedures except hysterectomy – where rates are significantly higher for African Americans than other ethnicities. I’ve often wondered if this was true for Māori women also. This study goes some way to answer the question. It is an audit, and therefore does not have power to show statically significant difference by ethnicity. However, as an audit is meant to be an exercise for improving ‘quality of care’, you have to wonder if Māori and Asian women (of whom only 75% and 60% were offered gold standard treatment) are receiving ‘lesser’ quality than NZE women (of whom more than 80% were offered it).
Independent commentary by Dr. Matire Hardwood
Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.
Research Review publications are intended for New Zealand health professionals.
Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.