Mind the Gap - making pessary use for pelvic organ prolapse woman-centred and evidence-based - a James Lind Alliance pessary priority setting partnership (Phase I)

Aim(s):

The aim of the project study is to:

  1. Identify the top ten priorities for future research relating to pessary use for pelvic organ prolapse for which there is no existing evidence.
  2. To conduct a systematic scoping review of the published research and synthesise the results to identify the levels of evidence and evidence gaps
  3. Use stages (i) and (ii) to inform a pilot study or feasibility trial protocol to answer one of the priorities identified in (i).

Summary:

Prolapse affects up to 50% of women. Treatments include surgery, which has a high reoperation rate, and conservative management which may involve the use of a vaginal device called a pessary. The current evidence- base for pessary use is limited with no available systematic reviews to inform practice. 

This mixed methods research project seeks to identify, by consensus, the top ten priorities for future research about pessary use for prolapse. A systematic scoping review and the priority setting exercise involving clinicians and women with experience of prolapse will illustrate what the evidence is and where the gaps are.

The scoping review to date has identified considerable gaps in evidence and highlighted inconsistencies and the lack of quality research. The questions submitted to the priority setting exercise demonstrate the wide level of uncertainties from women and clinicians.

The final workshop of the JLA Pessary PSP on 8th September will identify the top ten which will be published and promoted to increase the opportunity for funding research about this topic. Previously published James Lind Alliance ‘Top Tens’ have been significant in influencing funded research.

The collaborative and broad scope of this project gives voice to those involved with pessary provision and use. It is anticipated that publications relating to the Scoping Review, and the JLA Pessary PSP process and results will be submitted to the relevant journals.

The final phase of this project will investigate ways of answering an identified Top Ten by way of research with a feasibility or pilot project anticipated.

Principal Investigator: Professor Suzanne Hagen

NMAHP Research Unit Collaborators: Doreen McClurg

External Collaborators: Lough K - Glasgow Caledonian University

Funder: UK Continence Society and Pelvic Obstetric and Gynaecological Physiotherapy Group