Qualitative study exploring which research outcomes best reflect women’s experiences of heavy menstrual bleeding: stakeholder involvement in development of a core outcome set

Objective: This work contributed to the development of a core outcome set (COS) for heavy menstrual bleeding (HMB). The objective was to determine which research outcomes best reflect how HMB affects women’s lives and to identify additional research outcomes, not previously reported. It was important to explore and record participants’ reasoning for prioritising outcomes and use this information to reinforce the patients’ voice during later phases of the COS development.

Design: Patient workshop discussions and telephone interviews.

Setting: East London teaching hospital.

Participants: Inclusion criteria were that participants must be over 18 years old, that either they or their partner had a history of HMB and that they had a good understanding of written and spoken English.

Results: 41 participants were recruited for the study. 8 women and 1 man completed the study. The eight female participants were representative of the different underlying causes and treatments for HMB. Participants ranged in age from their early 20s to their 60s and represented a range of ethnic groups. The five main themes that were identified as being important to patients were: ‘restriction’, ‘relationships and isolation’, ‘emotions and self-perception’, ‘pain’ and ‘perceptions of treatment’. We identified eight coding nodes that did not correspond with our list of previously reported outcomes in studies of HMB. These nodes were consolidated and became five new outcomes for potential inclusion in the COS.

Conclusions: HMB stops women living their lives as they would wish. It affects their relationships, education, careers, reproductive wishes, social life and mental health. This is a condition of girls and women in the prime of their lives, but for many, the constant threat of a heavy period starting means that they sacrifice that freedom. The societal and economic costs of women being incapacitated every month has an effect on everyone.

Contributors

Natalie Ann MacKinnon Cooper, Sarah Yorke, Alex Tan, Khalid Saeed Khan, Carol Rivas

Publication

Journal: BMJ Open
Volume: 13
Issue:
Pages: -
Year: 2023
DOI: 10.1136/bmjopen-2022-063637

Further Study Information

Current Stage: Completed
Date:
Funding source(s): The core outcomes set for HMB is funded by an Academy of Medical Sciences Starter Grant for Clinical Lecturers which was awarded to NAMC. NAMC is an academic clinical lecturer funded by the National Institute for Health Research. KSK is a distinguished investigator funded by the Beatriz Galindo (senior modality) Programme Grant given to the University of Granada by the Spanish Ministry of Education.


Health Area

Disease Category: Gynaecology

Disease Name: Heavy menstrual bleeding

Target Population

Age Range: 13 - 50

Sex: Female

Nature of Intervention: Drug, Hormone, Surgery

Stakeholders Involved

- Consumers (patients)

Study Type

- Patient perspectives

Method(s)

- Interview
- Semi structured discussion

Patient workshop discussions and telephone interviews.