Introduction of a proforma in the management of under age attendees at a genitourinary clinic

Abstract

The aim of this review was evaluation of a recently developed proforma for improving assessment and management of patients under the age of 16 in the genitourinary (GU) medicine clinic. A case-note review of all under-16s attending between June 2000 and March 2001 was undertaken (109 patients). Comparison with review from 1998 prior to proforma introduction was carried out. In all, 99 proformas were completed. Fewer young patients were seen solely by junior doctors since proforma introduction (27-45%) (P=0.012), more were referred to health advisors (79% versus 66%) (P = 0.056),but follow-up remains suboptimal (72% versus 78%). Possibility of abuse was assessed in 102 patients (17 cases of non-consensual sex versus six in 1998). In all, 54% were using no contraception and only 21% were consistently using barrier methods; 41% had sexually transmitted infections diagnosed. The proforma is useful for collecting data and directing management when completed fully, and has revealed greater numbers of children involved in risky behaviour and abuse.

Management of Children and Adolescents with Gynaecological Problems in Primary Care

“…-have guidelines in place for risk assessment and management for child sexual abuse; -use a standardised proforma 24 for risk assessment (Appendix B) for all under 16 year olds and those 17-18 where there is a cause for concern or learning difficulties. The proforma can be amended according to local need; -be aware of local child protection procedures.…”

2013 UK national guideline for consultations requiring sexual history taking. Clinical Effectiveness Group British Association for Sexual Health and HIV

“…Facilitate audit. 10,57 Services should consider the range of data items in the light of their local and national health priorities and needs. For example, in Scotland, routine enquiry about gender-based violence was mandated in sexual health services in 2008 48 and a national minimum data set for all sexual health services was agreed in October 2011 to replace the STISS coding system.…”

Management of sexually transmitted infections in pubertal children

“…‘Working together to Safeguard Children’20 indicates the need to consider CSA in under-18 year olds who are sexually active. Additionally, a risk assessment should be performed on under-16 year olds or under-18 year olds if there is cause for concern20 21 with a standardised proforma possibly easier and more objective to administer 22…”