Patient Priorities for Interactions with Providers Treating Vulvovaginal Pain Conditions
Authors: Williams C , Bouvia M 
Published: July 2022

ABSTRACT

Introduction
Women with vulvovaginal pain conditions often see many providers while seeking diagnosis and treatment. Patients often struggle with logistical aspects of visits with a specialist, including concerns with time constraints, accessibility, and follow-up care.

Objective
The goal of this project was to determine which aspects of seeing a specialist for treatment of vulvovaginal pain are most important to patients. We also wanted to determine if there are differences in priorities for patients with different conditions within the umbrella of vulvovaginal pain, e.g., vestibulodynia vs. pelvic floor dysfunction vs. dermatological conditions. Finally, we sought to use the results to make suggestions for best practices for sexual medicine providers to improve their interactions with patients and better fulfill patient needs.

Methods
Patients completed a voluntary online survey hosted by Qualtrics. The survey allowed patients to self-identify their condition(s), if they felt comfortable, for use in refined data analysis. Opinion data was collected from patients in seven categories: website information, accessibility, clinic environment, bedside manner, process of care, knowledge and experience, and follow-up care. The survey asked respondents to share their opinions by ranking items in each category by their importance. Additionally, we asked patients to rank the categories by their importance. An average rank for each item was calculated for all respondents and using responses from only certain groups, i.e., patients who reported they experience pelvic floor dysfunction, to look for differences among patient groups.

Results
To date, ∼90% of respondents to the survey identified with diagnoses of vulvodynia, vestibulodynia and/or pelvic floor dysfunction. Preliminary analyses of responses showed that patients were most concerned with a provider's knowledge and experience. Within this category, the top concern was a provider's ability to accurately diagnose. The next most important category to patients was a provider's bedside manner. Within this category, patients most wanted a provider to believe in their symptoms and actively listen to their story. Some analyses of responses from patients reporting certain conditions identified unique priorities. For example, patients who identified as having chronic vaginitis / vaginal infection were more concerned with a provider's ability to select appropriate tests, not patronize patient's opinions, developing a treatment plan as a team, and a provider's responsiveness to urgent concerns. Respondents that that identified as having genitourinary syndrome of menopause had greater concern for provider's follow-up care and accepting insurance. Based on these results, we offer suggestions to providers for ways to improve interactions of patients with their practice, such as continuing education, efforts to empathize with patient experiences, and alterations to modes of communication.

Conclusions
Women with vulvovaginal pain conditions, e.g., vulvodynia, vestibulodynia, and pelvic floor muscle dysfunction, often see many providers. By taking patient opinions into consideration, providers can optimize their interactions with patients to better fulfill their needs, increase patient trust in the provider, and decrease time to diagnosis.

Disclosure
No