June 21, 2018

Interdisciplinary approach crucial to care of women in menopause

Photo: Paul Swanson Photography

Lois Hole Hospital for Women Interdisciplinary menopause clinic

Women in menopause often experience a complex mix of health issues, so the kind of one-size-fits-all approach that might be taken to their care can leave them feeling frustrated and alone. With this in mind, the team at the Lois Hole Hospital for Women’s menopause clinic embarked on a study of nearly 200 patients, to fill a research gap in patients’ issues and subsequent treatment at interdisciplinary clinics like theirs.

Family doctor Tami Shandro works at the clinic, in concert with a range of experts–including gynecologists, pharmacists, registered nurses and dietitians–a collaboration she stresses is crucial in addressing the complex needs of patients. “We all have our expertise in different areas,” she said. “I’m so blessed to be able to work with this team, and with the research team.” Behind the scenes, cooperation occurs on research projects, with statistical and qualitative teams from the Women and Children’s Health Research Institute providing invaluable support to clinic staff. Through the Alberta Women’s Health Foundation, WCHRI offers financial support, as well, in the form of a variety of research grants. This assistance helps fund research like the recent retrospective chart study, which tracked the symptoms and care of 198 patients.

“We discovered (in this study) that the majority of our patients have a chronic health issue (like diabetes or lung disease), and often they’d have three or four,” said Shandro. Menopausal symptoms were occurring in addition to the symptoms associated with their chronic health issues. Of the menopausal symptoms, the research showed that sleep problems were by far the most common and bothersome complaint for patients, with sexual dysfunction a close second.

In this evidence-based clinic, said Shandro, research inevitably leads to marked changes in patient care. When the chart study showed that more than 76 per cent of patients had severely fragmented sleep and nearly 74 per cent reported chronic tiredness, for example, she decided to seek further training in sleep disorders to better address that need. Research like this also tends to lead to more and deeper questions. “Now we’re going on to study how quality of life” is affected by the symptoms the patients reported, added Shandro, and by the subsequent hormone therapy they’re given. That in turn leads to yet more questions about, on a broader level, how to ensure more women have prompt access to the resources they most need.

“We need to be more timely in our introduction of care for these women,” said Shandro, and right now a months-long wait list at the clinic makes that difficult. Research like the chart study “helps get the word out that this kind of clinic is very important for women’s well-being.” Ultimately, Shandro and her colleagues would like to see more clinics offering the kind of interdisciplinary care needed to address the often complex health issues of women in menopause.

Research through the menopause clinic has been supported by the Alberta Women’s Health Foundation through WCHRI.