Contraception: Knowledge and prescribing practices of Canadian healthcare providers
ESC Congress Library. Cook J. 05/10/18; 208211; ESC322 Disclosure(s): Some financial support received by Bayer.
Dr. Jocelynn Cook
Dr. Jocelynn Cook
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Abstract
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Contraception is an important issue in the lives of women, their partners and society.   Evolving preferences, technologies, values and reproductive cultures, in general, can influence fertility, family size, family planning, and choice of occupation. Canadians and their health care providers play a critical role in fertility and contraception-related decisions and practices that fundamentally influence individual lives and society. Unplanned pregnancies are still of significant concern around the world and have been recently reported at a 61% prevalence in Canada. Research has shown that contraceptive counseling has an influence on women's family planning outcomes, but also that women are often dissatisfied with the counseling they receive.  Healthcare providers play a critical role in educating patients about contraception and counselling them toward choosing the best options for their short-term, long-term goals and their lifestyle.  The purpose of this study was to gather data on contraception-related knowledge, counselling and prescribing practices of Canadian healthcare providers, with a focus on IUCs, that will be used to inform the development of tools, resources and educational programming. The Society of Obstetricians and Gynaecologists of Canada (SOGC) worked with content experts to develop a two-part accredited training program targeted for primary healthcare providers and pharmacists in Canada.  Part 1 was an on-line program, designed to educate and create awareness about contraceptive options, and to determine education gaps and requirements.  Part 2 targeted primary healthcare physicians and consisted of a practice assessment that measured and explored their contraceptive counseling and prescribing practices.  Over 4,300 health care providers completed the program between July 6, 2015 and  January 12, 2016.  Although there was a trend for an improvement in knowledge, pre- and post-test scores did not differ significantly (t = -1.24; p = 0.12).  After completing the online program, both pharmacists (t= -6.91036; p= < 0.00001) and primary healthcare providers (t= -3.1934; p= 0.006369) felt more comfortable, knowledgeable and would change their practice around prescribing IUCs. Participants requested more information on the mechanism of IUCs, additional case studies and training on insertion. All patients received counselling and/or were offered some type of contraception; both short and long-acting types of contraception were most often discussed/offered (71% of the time), followed by LARC only (23%) and short-acting only (6%). This training program filled an education need and gave physicians tools to change their behaviour and practice around IUC prescribing.  A practice-assessment model is a successful way to change behaviour.
Contraception is an important issue in the lives of women, their partners and society.   Evolving preferences, technologies, values and reproductive cultures, in general, can influence fertility, family size, family planning, and choice of occupation. Canadians and their health care providers play a critical role in fertility and contraception-related decisions and practices that fundamentally influence individual lives and society. Unplanned pregnancies are still of significant concern around the world and have been recently reported at a 61% prevalence in Canada. Research has shown that contraceptive counseling has an influence on women's family planning outcomes, but also that women are often dissatisfied with the counseling they receive.  Healthcare providers play a critical role in educating patients about contraception and counselling them toward choosing the best options for their short-term, long-term goals and their lifestyle.  The purpose of this study was to gather data on contraception-related knowledge, counselling and prescribing practices of Canadian healthcare providers, with a focus on IUCs, that will be used to inform the development of tools, resources and educational programming. The Society of Obstetricians and Gynaecologists of Canada (SOGC) worked with content experts to develop a two-part accredited training program targeted for primary healthcare providers and pharmacists in Canada.  Part 1 was an on-line program, designed to educate and create awareness about contraceptive options, and to determine education gaps and requirements.  Part 2 targeted primary healthcare physicians and consisted of a practice assessment that measured and explored their contraceptive counseling and prescribing practices.  Over 4,300 health care providers completed the program between July 6, 2015 and  January 12, 2016.  Although there was a trend for an improvement in knowledge, pre- and post-test scores did not differ significantly (t = -1.24; p = 0.12).  After completing the online program, both pharmacists (t= -6.91036; p= < 0.00001) and primary healthcare providers (t= -3.1934; p= 0.006369) felt more comfortable, knowledgeable and would change their practice around prescribing IUCs. Participants requested more information on the mechanism of IUCs, additional case studies and training on insertion. All patients received counselling and/or were offered some type of contraception; both short and long-acting types of contraception were most often discussed/offered (71% of the time), followed by LARC only (23%) and short-acting only (6%). This training program filled an education need and gave physicians tools to change their behaviour and practice around IUC prescribing.  A practice-assessment model is a successful way to change behaviour.
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