Awareness of the risk of VTE associated with combined hormonal contraception.
ESC Congress Library. Mullin N. May 4, 2016; 126884; A-058
Dr. Nicola Mullin
Dr. Nicola Mullin
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Abstract
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Objectives
To discover the level of knowledge of clinicians working in a contraception and sexual health service health regarding the risk of venous thromboembolism (VTE) in women taking combined oral hormonal contraception (COC).

Method
In July 2015 the Faculty of Sexual and Reproductive Healthcare, UK (FSRH) issued a statement to its doctor and nurse members on the VTE risk with COC in response to the latest published evidence1,2
We work in an integrated contraception and sexual health service and decided to investigate our colleagues level of knowledge about VTE risk and COC; to discover if clinicians were up-to-date and understood FSRH guidelines on prescribing COC, using a voluntary individually completed quantitative and qualitative questionnaire.

Results
Early results from 9 different clinicians, 4 specialist contraception and sexual health nurses and 5 doctors in genitourinary medicine, from a level 3 service, showed a range of answers to each question. The only consistent answers were all clinicians would offer a levonorgestrel (LNG) containing combined oral contraception pill to first time users, and were able to indentify at least 6 additional risk factors for VTE, in line with FSRH guidance. Only two members of staff (2/9, 22%) successfully completed a table quantifying risk of VTE in non-users/not pregnant, postpartum, during pregnancy and with different classes of COC; and only 1/9 (11%) could give an example of each type or generation of progestogens when asked to list four types. More individuals (6/9) knew that the risk of a VTE decrease over the first few months of COC use.

Conclusion
Doctors and nurses in our integrated service do not seem to be fully up-to-date in their knowledge of VTE risk with COC but do understand and apply FSRH guidelinesfor the safe prescribing of CHC to patients. We plan to offer the questionnaire to the remaining clinical staff in the service and will identify and address any training needs.

References

1. Use of combined oral contraception and risk of venous thrombosis. Statement from FSRH Clinical Effectiveness Unit, May 2015

2.Vinogradova Y et al. Use of combined oral contraceptives and the risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ 2015;350:h2135. 26 May 2015

3. FSRH Clinical Effectiveness Unit Guideline on Combined Hormonal Contraception, October 2011 (updated August 2012)

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