July 2024

Temporal trends in tranexamic acid prescribing for heavy menstrual bleeding by Australian general practice trainees

Kristen Hamilton,¹ Parker Magin,^2–4 Amanda Tapley,^2,3 Jason Dizon,⁵ Elizabeth Holliday,² Charlotte Hespe¹
 

¹The University of Notre Dame Australia, Department of General Practice and Primary Care Research, Sydney, NSW

²The University of Newcastle, School of Medicine and Public Health, Newcastle, NSW

³The Royal Australian College of General Practitioners, General Practice Training Research Department, Newcastle, NSW

⁴The University of New South Wales, School of Public Health and Community Medicine, Sydney, NSW

⁵The Hunter Medical Research Institute, Clinical Research Design IT and Statistical Support Unit (CReDITSS), Newcastle, NSW

---

Background and objectives

Evidence-based prescribing for heavy menstrual bleeding (HMB) can improve quality of life, iron deficiency and anaemia. Tranexamic acid (TXA) is more effective than oral hormonal medications (OHMs) for HMB. This study aimed to establish temporal trends (2010–23) in TXA prescribing for HMB by general practice registrars.

Methods

Analyses, using multivariable mixed logistic regression models, were conducted within the Registrar Clinical Encounters in Training (ReCEnT) study.

Results

Adjusted odds of prescribing TXA for HMB increased by 12% per year (OR 1.12, 95% CI [1.04, 1.20], P=0.004), and 18% per year when compared to OHMs (OR 1.18, 95% CI [1.03, 1.36], P=0.019). General practice registrars who consulted their supervisor were less likely to prescribe TXA compared to OHMs (OR 0.36, 95% CI [0.14, 0.92], P=0.034).

Discussion

Registrars’ increasing TXA prescribing suggests an appropriate response to evidence. Association of OHM prescribing with supervisor consultation might suggest supervisors are slower to implement this evidence than registrars.