A collaborative approach to a regional endometriosis service

Endometriosis is a debilitating condition affecting at least one in nine people in Australia assigned female at birth. Despite its prevalence, diagnosis often takes an unacceptable average of seven years. Endometriosis impacts organs in the reproductive, urinary and gastrointestinal systems and can require fertility, physical and mental health support. A chronic inflammatory disease, endometriosis involves tissue similar to the lining of the uterus growing elsewhere in the body, with treatment costing an average of $30,000 annually per person affected.

As a recognised national health priority, recent campaigns have highlighted the need to raise awareness and improve care. In 2018, the Hon Greg Hunt, then Minister for Health, issued a public apology on behalf of the Australian Parliament and medical system for the historic failures that sufferers of endometriosis endured, stating ‘Australian women … no longer have to battle this in private.’

In response to the national call for action, Obstetrics and Gynaecology Ballarat (OGB) and OGB Surfcoast implemented the Co-designed Approach to a Regional Endometriosis Service (OGB CARES) model. Designed to ensure access to the highest quality of care for those living in regional Victoria, the OGB CARES model is focused on creating a pathway that involves a range of service providers and health resources with focused expertise.

Dr Russell Dalton, founder of OGB CARES, explains, ‘We aim to provide a service that all women, irrespective of financial status, will be able to access and receive personalised, timely support.’

Anna Price-Smith was appointed as the Endometriosis Nurse Coordinator to ensure the success of the service. Anna has played a pivotal role in engaging consumers and co-designing the patient-centred mission statement and intake questionnaires. Anna also has lived experience of endometriosis and is passionate about improving care services for people with endometriosis.

Under the OGB CARES model, collaborative research partnerships are being formed. Engagement from consumers and academic research centres will advance the understanding and treatment of endometriosis, with support from the OGB Research Foundation.

One such project involves evaluation of a clinical pathway for triaging pelvic MRI in management of deep infiltrating endometriosis of the bowel, led by Principal Investigator Dr Madeleine Ward in collaboration with Epworth Medical Imaging, the Julia Argyrou Endometriosis Centre Epworth (JAECE) and Deakin University.

Another planned project involves a prospective study on the efficacy of Tung acupuncture therapy in pelvic pain management for patients with endometriosis, led by Associate Professor Mike Armour in collaboration with traditional Chinese medicine practitioner Naomi Jankowski and OGB gynaecologist Dr Alexandra Bonner.

Additionally, an Endo Art project is underway, led by Dr Edwina Coghlan and community artist Rachel Harrison, in partnership with JAECE, to evaluate the impact of creative expression on the psychological wellbeing of endometriosis patients.

Anna Price-Smith says, ‘OGB CARES brings together a team of dedicated health professionals who deliver a holistic approach to endometriosis care. Our patients are at the centre of everything we do, and we are committed to improving their health outcomes and overall wellbeing.’

The OGB CARES model also ensures that those who live outside metropolitan areas experience fewer barriers to accessing health care. By providing streamlined referral pathways and telehealth consultations, patients can access care from the comfort of their own homes. This is particularly important for those living in rural communities, who face unique barriers to accessing health care.

As Dr Lachlan Brennan explains, ‘OGB CARES provides a community-specific model of care that is tailored to meet the needs of people living in rural areas.’