The Library
Acceptability of and treatment preferences for recurrent bacterial vaginosis—Topical lactic acid gel or oral metronidazole antibiotic : Qualitative findings from the VITA trial
Tools
Tools
Tools
Anstey Watkins, Jocelyn, Ross, Jonathan D. C., Thandi, Sukhwinder, Brittain, Clare, Kai, Joe and Griffiths, Frances (2019) Acceptability of and treatment preferences for recurrent bacterial vaginosis—Topical lactic acid gel or oral metronidazole antibiotic : Qualitative findings from the VITA trial. PLoS One, 14 (11). e0224964. doi:10.1371/journal.pone.0224964 ISSN 1932-6203.
|
PDF
WRAP-acceptability-treatment-recurrent-bacterial-vaginosis-acid-Griffiths-2019.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (621Kb) | Preview |
Official URL: http://doi.org/10.1371/journal.pone.0224964
Abstract
Background
Bacterial vaginosis (BV) is associated with an elevated vaginal pH and the presence of abnormal offensive discharge. It is common, often recurrent, and the most effective treatment regimen is unknown. ‘Metronidazole Versus lactic acId for Treating bacterial vAginosis’ (VITA) is a UK-based randomised controlled trial assessing clinical and cost-effectiveness of topical lactic acid gel compared to oral metronidazole antibiotic for treating second and subsequent BV episodes. Few BV trials report on women’s preferences for treatment in the context of their own experiences.
Method
This qualitative study investigated the acceptability and tolerability of the two treatments. During the trial, semi-structured telephone interviews were undertaken between January—May 2018. A total of 33 women diagnosed with BV were consecutively sampled then interviewed from six sites across England. Thematic analysis was guided by the acceptability of health interventions framework. Potential causes of BV and its impact on women’s lives were explored in addition to women’s treatment preference and perceived treatment effectiveness.
Results
Although women felt antibiotics treat BV effectively, and were associated with longer time periods between episodes, they generally preferred using the lactic acid gel because of ease of use, once daily application and less side-effects. Women would recommend the lactic acid gel to others for mild cases of BV but to take antibiotics when more severe. The risk of antibiotic drug resistance was a common concern. Self-help medicating or self-decision to not treat was also evident due to prior experience of poor outcomes from treatment. Triggers of BV were attributed to personal hygiene habits–soaps used to wash the vagina and sexual practices such as unprotected sex.
Conclusion
Acceptability and preference for topical lactic acid gel or oral metronidazole tablets in the treatment of recurrent BV was affected by personal choice relating to affective attitude, burden, ethicality, intervention coherence, opportunity costs, and self-efficacy. These differed depending on ease of use, tolerability and past experiences, but not necessarily based on perceived drug effectiveness. Knowledge of a patient preference for topical lactic acid gel therapy despite lower perceived effectiveness may be useful for clinicians when making treatment decisions.
| Item Type: | Journal Article | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RG Gynecology and obstetrics | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||||||
| Library of Congress Subject Headings (LCSH): | Bacterial vaginitis, Bacterial vaginitis -- Treatment | ||||||||
| Journal or Publication Title: | PLoS One | ||||||||
| Publisher: | Public Library of Science | ||||||||
| ISSN: | 1932-6203 | ||||||||
| Official Date: | 15 November 2019 | ||||||||
| Dates: |
|
||||||||
| Volume: | 14 | ||||||||
| Number: | 11 | ||||||||
| Article Number: | e0224964 | ||||||||
| DOI: | 10.1371/journal.pone.0224964 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 27 November 2019 | ||||||||
| Date of first compliant Open Access: | 27 November 2019 | ||||||||
| RIOXX Funder/Project Grant: |
|
Request changes or add full text files to a record
Repository staff actions (login required)
 |
View Item |
Downloads
Downloads per month over past year
