Temporizing Medications for Nonpregnant Patients Discharged from the Emergency Department with Abnormal Uterine Bleeding at a Single Urban Teaching Hospital
Abstract
Learning Objectives: To determine if patients evaluated for nonpregnant, abnormal uterine bleeding (AUB) are discharged from the Emergency Department (ED) with medications to temporize or improve their acute bleeding episode.
Background: Abnormal uterine bleeding (AUB) is common and has a significant impact on a woman’s quality of life. When bleeding is heavy it can be distressing and often prompts visits to an emergency department (ED). Temporizing treatments for AUB include hormonal therapies, such as combination oral contraceptive pills and progestin-only medications, and non-hormonal therapies such as nonsteroidal anti-inflammatory drugs (NSAIDS) and tranexamic acid. It is unclear what percent of these patients are discharged home with a temporizing treatment or if opportunities for improvement exist.
Objectives: To determine if patients evaluated for nonpregnant, AUB are discharged from the ED with medications to temporize or improve their acute bleeding episode.
Methods: A retrospective chart review of nonpregnant patients who were discharged after ED evaluation for AUB. Medical records were systematically reviewed with a focus on ED evaluation and discharge prescriptions.
Results: Of the 100 patients that met inclusion criteria, 94 were included in the final analysis. Of these 94 patients, a total of 24 patients (25.5%) were discharged with a prescription for a medication to treat AUB.
Conclusion: In this retrospective chart review of non-pregnant patients presenting to the ED with abnormal uterine bleeding, we analyzed how many received a prescription for a temporizing medication. After analyzing 94 visits for AUB to a major Washington D.C. emergency department, the results support our hypothesis that many of these patients would not receive a prescription at time of discharge. Of the patients who did receive a prescription, the majority were given over the counter NSAIDs with only a third of the patients evaluated being given an OCP or TXA.