Cervicitis in Adolescents: Do Clinicians Understand Diagnosis and Treatment?
Cervicitis in Adolescents: Do Clinicians Understand Diagnosis and Treatment?
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DOI：
10.1016/j.jpag.2011.06.006
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发表时间：
2011-12-01
影响因子：
1.8
通讯作者：
Scurlock, Amy M.
中科院分区：
文献类型：
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作者：
Woods, Jennifer L.;Bailey, Sarabeth L.;Scurlock, Amy M.
背景：宫颈炎症很普遍，但还没有研究根据既定的诊断和治疗指南来检查宫颈炎症。研究目标是描述青少年人群中遵守疾病控制和预防中心诊断和治疗宫颈炎症指南的情况，并比较初级保健环境和急诊科遵守指南的相关因素。方法：收集数据作为对门诊青少年女性性传播感染评估、诊断和治疗的回顾图表的一部分。如果参与者年龄在12-21岁，并被给予ICD-9和宫颈炎症诊断图表，则有资格进行审查。研究使用了两个主要结果变量：符合宫颈炎症指南和符合宫颈炎症指南的正确治疗(否/是)：研究控制了年龄、种族、地点、既往衣原体或淋病感染。结果：受试者(n=365)检查了主要结果变量，75.1%(274/365)满足至少一个宫颈炎症标准。其中，166名(60.9%：166/274)受试者仅符合宫颈炎症标准，而同时符合宫颈炎症和盆腔炎(PID)标准的受试者(39.4%：108/274)。89.3%(326/365)的患者同时对衣原体和淋病进行了治疗，但仅有64.7%(211/326)的患者对这两种感染进行了正确的治疗。结论：青少年患者对宫颈疾病的诊断和治疗以及对宫颈炎症和盆腔炎的鉴别认识不足。教育工具、模拟患者练习和医嘱集可能需要提高质量，以便改善对这些高危性活跃人群的护理。
Background: Cervicitis is widespread, but no studies have examined cervicitis in accordance with established guidelines for diagnosis and treatment. Study objectives were to describe adherence to Centers for Disease Control and Prevention guidelines for diagnosis and treatment of cervicitis within an adolescent population and to compare factors associated with adherence to guidelines in a primary care setting and the Emergency Department.Methods: Data were collected as part of a retrospective chart review of evaluation, diagnosis, and treatment of STI in adolescent women in an outpatient setting. Participant charts were eligible for review if they were 12-21 years of age and were given an ICD-9 and chart diagnosis of cervicitis. Two primary outcome variables: meeting cervicitis guidelines and correct treatment among those meeting cervicitis guidelines (no/yes) were utilized: the study controlled for age, race, venue, past infection with chlamydia or gonorrhea.Results: Subjects (n = 365) were examined for the primary outcome variables and 75.1% (274/365) met at least one criterion for cervicitis. Of these, 166 (60.9%: 166/274) subjects were found to meet criteria for cervicitis alone, versus subjects meeting criteria for both cervicitis and pelvic inflammatory disease (PID) (39.4%: 108/274). The majority, 89.3%, (326/365) were treated for both chlamydia and gonorrhea, but only 64.7% (211/326) were treated correctly for both infections.Conclusions: Our findings suggest that knowledge deficits exist in diagnosis and treatment of cervicitis in adolescent patients and in differentiating between cervicitis and PID. Educational tools, simulated patient exercises, and order sets may be warranted for quality improvement to allow for improved care of this at risk sexually active population.