The ePAQ vulva questionnaire has been validated and developed at Sheffield Teaching Hospitals NHS Foundation Trust and Sheffield University Medical School to specifically assess women with vulvar disease . It can be completed in clinic or at home online, prior to specialist consultation . The questionnaire allows for the assessment of women across four different domains: pain & discomfort, skin changes, sexual function, and quality of life. Symptom frequency and impact on quality of life is assessed for each of these domains. ePAQ-Vulva also records demographic information and behaviours, as well as medical co-morbidities, which may affect vulvar disease.
A survey regarding implementation of ePAQ Vulva was completed by 61 women attending a multidisciplinary vulvar clinic in Sheffield, UK. Multiple drafts of the questionnaire were modified by vulvar clinic specialists and a final electronic version was produced.
An initial literature review revealed that there was no electronic questionnaire in existence to assess women with vulvar disease. The results of the survey identified that women wanted clinicians to better address their feelings and perceived concerns related to their vulvar condition. In addition free-text questions allow women to express their beliefs, ideas and expectations regarding their condition.
By using ePAQ-Vulva, the clinician has access to more information on how a woman’s condition is affecting her life, which symptoms are most bothersome, and what their beliefs and expectations about their condition are. This allows for a more focussed and individualized consultation and enables a quantitative assessment of responses to treatment.
ePAQ-Vulva has been used at STH since April, 2014 and has been studied to document the initial experiences with the instrument .
Reference 1 describes how data was collected from women attending the vulvar clinic between April - December 2014 and were analyzed using baseline statistics. Data included ePAQ-Vulva voucher issue rates and subsequent completion rates.
135 of 157 women were issued a voucher. Sixteen eligible women were not issued a voucher; and three were ineligible. 89 completed (six submissions incomplete), but 40 did not utilize the ePAQ-Vulva voucher. From September 2014, a medical student was appointed as a clinical support-worker for ePAQ-Vulva. Overall completion rate pre support-worker was 61% and post was 68%. Completion rates were similar in the age groups 41–50, 51–60, and 61–70 (76%, 79% and 70% respectively). Completion rates in the 71–80 and 81–90 groups were lower at 53% and 18%. Lichen sclerosus was the most common diagnosis on the clinic (62.5%), followed by VIN (13%) and vulvodynia (9%).
The study found that using a support-worker increased uptake of ePAQ-Vulva and should form a permanent role in the clinic. Older women were less likely to complete ePAQ-Vulva, probably due to computer literacy issues. Greater support and alternative options need to be considered for these patients. ePAQ-Vulva allows a large amount of demographic data to be recorded and is useful for evaluating the service provided in the vulvar clinic at Sheffield Teaching Hospitals.