Hospital Les Bleuets – Reims, was one of the three finalists for the European Private Hospital Awards 2023, in the Best patient focused initiative category, with its pain management programme for patients with endometriosis.
Endometriosis is a chronic disease that affects women of childbearing age and is characterised by the presence of endometrial tissue outside the uterus, causing pelvic pain, abnormal bleeding and infertility.
The most recent epidemiological data indicate that endometriosis affects approximately 10% of women of childbearing age worldwide. In France, the incidence of endometriosis is estimated at about 1 in 10 women, i.e. about 2 million women with the disease. However, this figure is considered to be an underestimate as many women suffering from endometriosis are not diagnosed or are not counted in official statistics.
It is important to note that endometriosis can be difficult to diagnose due to non-specific symptoms and may therefore be under-diagnosed. Increased awareness and understanding of the disease could contribute to earlier detection and better management of women with endometriosis.
In collaboration with gynaecologists and a psychiatrist in the region, we have created a pain management programme for patients with endometriosis. Patients can be referred to the programme by their gynaecologist, psychiatrist or pain doctor at the university hospital. The specialist doctor will refer them to the coordinating doctor of the day care unit (HDJ), who will carry out a multidisciplinary assessment before determining their treatment plan. Summary meetings will be organised with the different specialists involved.
Our initiative aims to provide a holistic approach to the management of endometriosis. It aims to improve the quality of life of patients by reducing their pain, disability and loss of autonomy, as well as promoting their social and professional reintegration.
To achieve this, a multidisciplinary team implements different areas of care, in particular care of the abdomen and spine, the regaining of self-confidence, nutritional and psychological care, as well as overall functional rehabilitation.
The technical platform is composed of an APA gym and a physiotherapy platform, access to balneotherapy, sophrology, relaxation, yoga and pilates workshops, TENS (Transcutaneous electrical nerve stimulation) with training, therapeutic information workshops, access to mesotherapy and manual therapy, and the Qutenza patch.
The treatment plan is personalised, with an initial assessment and takes into account the patient’s pain and fatigue. The sessions take place in half-day sessions, one to five per week, with an intermediate multi-professional synthesis and consultations with treating physicians, algologists, psychiatrists, etc…
The people involved in the management of endometriosis each have a specific role to play:
- The nurse coordinator is responsible for creating a schedule adapted to the patient’s needs.
- The pain nurse provides personalised pain monitoring, uses TENS techniques to relieve pain, actively listens to the patient and de-dramatises the pain. She can also propose the application of a QUTENZA patch to treat neuropathic pain.
- The EAPAS (health adapted physical activity teacher) aims to use sports activities to get the patient moving again, to fight against the spiral of pain and to carry out an assessment of the general physical condition.
- The dietician, as for her, works on the patient’s diet and her management objectives are to limit pain through an anti-inflammatory diet, to limit exposure to endocrine disruptors and to use micro-nutrition, phytotherapy and aromatherapy to reduce pain.
- The physiotherapist’s aim is to manage the symptoms of pain, improve the patient’s mobility and physical capacities. He carries out a complete physical assessment, offers dry and balneo sessions, carries out manual treatments, uses physiotherapy techniques (TENS, thermotherapy), works on relaxation, respiratory and diaphragmatic work, and strengthens the muscles.
- The psychologist participates in the recovery of self-confidence through psychic support and relaxation sessions (relaxation and sophrology)
Finally, the occupational therapist carries out an assessment of the activities of daily living, discusses with the patient her living habits, complaints and pain, and proposes environmental readaptations of the home or the workplace.