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Evaluating Patient Understanding of the “diagnosis of Pregnancy of Unknown Location”

Purpose: To evaluate health literacy in an inner city population among a high risk group of resident-managed patients with a diagnosis of pregnancy of unknown location.

 

Background: Low health literacy is associated with poor reproductive health outcomes. Previous research on patient compliance with methotrexate protocols as treatment for ectopic pregnancy has shown poor compliance (as low as 10%).  Rates of follow up after diagnosis with pregnancy of unknown location are not well described.

 

Methods: A chart review was performed to identify of all patients seen in an inner city hospital with the diagnosis of pregnancy of unknown location. Patients meeting inclusion criteria were contacted by phone to survey understanding of the rationale for close follow up. Patients who never followed up after initial contact were excluded.

 

Results: Eighty seven patients with the diagnosis of pregnancy of unknown location were identified between January – April 2018.  Twenty nine patients met inclusion criteria and twenty agreed to participate. Only 40% of patients correctly explained that there was a concern for ectopic pregnancy. The remaining patients identified their diagnosis as an “abnormal pregnancy” (10%), “miscarriage” (10%); “I don’t know” (15%), and other (25%). 

 

Discussions: Although the patients surveyed were compliant with follow up, nearly half of the patients showed poor comprehension of their clinical condition. It may be that poor understanding is a major underlying cause for noncompliance for the many patients who never followed up. This should be evaluated in future research.  

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Residency Director, Residency Coordinator, Patient Care, Medical Knowledge, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, GME, Quality & Safety, Public Health, General Ob-Gyn,

General Information


Intended
Audience
Student,Resident,Faculty,Residency Director,Residency Coordinator,
Competencies
Addressed
Patient Care,Medical Knowledge,Systems-Based Practice & Improvement,Interpersonal & Communication Skills,
Educational
Continuum
GME,
Educational
Focus
Quality & Safety,Public Health,
Clinical Focus
General Ob-Gyn,

Author Information

Yiran Xu, MD, Temple University Hospital; Sarah Ackroyd, MD, MPH; Molli Bascom, MD; Sarah Bruce, BA; Margaret Rush, BS; Kathryne Sanserino, MD

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