FIGURE 1 Map of Medicine Pelvic Pain Page for Primary Care.
The map appears as a flow chart (see Fig. 1) and an information button is provided on many of the boxes. Clicking on the information button opens an information window which provides clear, yet concise information about the activity contained in the box. The information also contains references.
The whole map can be downloaded as a PDF document. In this form, the flow chart is contained on the first page of the document and the information boxes are reproduced on the subsequent pages. The primary care map translates into a 16 page PDF document and the secondary care (specialist care management) map translates into a 12 page document. The disadvantage of the downloaded documents is that they do not benefit from the updating process that is central to the Map of Medicine concept. However, the documents have proved popular in educational groups that the author has held both for primary care and secondary care colleagues. The primary care document is more detailed and prescriptive than the secondary care document and this has been found to be appropriate during teaching sessions using the map, with the non-specialist primary care audience appreciating the extra detail given.
PRACTICAL IMPLICATIONS
Approximately 1 million women in the UK have pelvic pain, with the prevalence of chronic pelvic pain in women being estimated at 38 per 1,000 [3], which is similar to the prevalence of asthma [1] or back pain. The prevalence in men has not been directly established, but referrals are common, with pain in the area of the prostate, testicles, penis and bladder. Clearly, it is not going to be possible for all of these patients to be treated in specialist clinics. Fortunately, if the care of these patients is properly coordinated, much, if not most, of their care can be delivered in primary care. The Map of Medicine pathways for patients with chronic pelvic pain make this possibility more of a reality, by giving clinicians the information that they need in a useable form that is evidence based and up to date.
The Map of Medicine pelvic pain pathway has been written by a multidisciplinary group and it can be used to break down the barriers between primary care and the different specialists that see and treat patients with chronic pelvic pain. Currently, the care a patient receives is often dependent more upon where they are seen, rather than the clinical condition from which they suffer. If it is used enthusiastically and adapted to local conditions, this BPS Map of Medicine pain pathway series will help all clinicians deliver the right care at the right time, making it more likely that patients will get greater benefit from their treatment. In the longer term this will reduce the wastage of healthcare resources and people’s lives.
LOOKING AT THE FUTURE
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