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Temporal trends in tranexamic acid prescribing by Australian general practice registrars for heavy menstrual bleeding
Amanda Tapley1, Elizabeth G Holliday2, Parker Magin3
1BBiomed, MD, DRANZCOG, FRACGP, Lecturer, Department of General Practice and Primary Care Research, The University of Notre Dame, Sydney, NSW; General Practitioner, Glebe Family Medical Practice, Sydney, NSW.
Background And Objectives:
Evidence-based prescribing for heavy menstrual bleeding (HMB) can improve quality of life, iron deficiency and anaemia. Tranexamic acid (TXA) is more effective than oral hormonal medications (OHMs). This study aimed to establish temporal trends (2010-23) in TXA prescribing for HMB by Australian general practice registrars.
Method:
Cross-sectional analyses were conducted within an ongoing inception cohort study (Registrar Clinical Encounters in Training [ReCEnT]), using multivariable mixed logistic regression models.
Results:
In 4717 registrars (response rate 93.4%), adjusted odds of prescribing TXA for HMB increased by 12% annually (odds ratio [OR] 1.12, 95% confidence interval [CI]: 1.04-1.20], P=0.004), and 18% annually when compared to OHMs (OR 1.18, 95% CI: 1.03-1.36, P=0.019). General practice registrars who consulted their supervisor were less likely to prescribe TXA compared to OHMs (OR 0.36, 95% CI: 0.14-0.92, P=0.034).
Discussion:
Registrars' increasing TXA prescribing suggests an appropriate response to evidence. Supervisors may be slower to implement this evidence, warranting further investigation to inform evidence-based prescribing strategies.
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