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Pelvic inflammatory disease in primary care.

W L Freeman1, L A Green, L A Becker

  • 1ASPN, Denver, CO 80202.

Family Medicine
|May 1, 1988
PubMed
Summary

Pelvic inflammatory disease (PID) in primary care often presents less severely than expected. Clinicians hospitalized only 9% of PID patients, despite 43% meeting hospitalization criteria, raising questions about optimal management.

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Area of Science:

  • Primary care medicine
  • Infectious disease epidemiology
  • Women's health

Background:

  • Pelvic inflammatory disease (PID) is a significant health concern with potentially severe consequences.
  • Existing clinical descriptions of PID often depict more severe presentations than observed in primary care.

Purpose of the Study:

  • To describe the clinical presentation and management of PID in a primary care setting.
  • To compare primary care PID management with published recommendations and assess potential cost implications.

Main Methods:

  • An observational study was conducted by the Ambulatory Sentinel Practice Network (ASPN).
  • Data were collected over 14 months (1982-1983) from 38 practices across 16 US states and two Canadian provinces.
  • 384 first visits for patients diagnosed with PID by clinicians were reported.

Main Results:

  • PID diagnosed in primary care was generally less severe, with fewer patients exhibiting fever, palpable adnexal masses, or extensive tenderness compared to other series.
  • Despite 43% of patients meeting criteria for hospitalization, only 9% were hospitalized initially.
  • This hospitalization rate was comparable to that reported by office gynecologists in a national study.

Conclusions:

  • The management of PID in primary care may differ from hospital-based or specialist settings.
  • The discrepancy between recommended and actual hospitalization rates warrants further investigation into optimal primary care management strategies for PID.
  • Understanding primary care PID management is crucial given the potential for serious sequelae and significant financial implications of different treatment approaches.

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