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Evaluation of Clinician Prescribing Practices for Contraceptive Care: A Quality Improvement Collaboration
Desrochers, Julie
Desrochers, Julie
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Abstract
Purpose: Primary care providers (PCPs) have the training and opportunity to provide contraceptive care. Unplanned pregnancy is a major public health issue for which up to 50% of the population is at overall lifetime risk. Reproductive life planning during healthcare visits can reduce rates of unintended pregnancy, prompting contraception or preconception planning. Studies suggest contraceptive counseling protocols and reproductive intent screening are effective tools. This project compares clinician behaviors with best practices. The purpose is to evaluate preventive reproductive healthcare practices in primary care, identifying opportunities to meet the contraceptive healthcare needs for people of reproductive age. Methods: PCPs and office managers in a central Vermont practice group were sent separate surveys. Surveys contained validated questions from three United States policy and governmental groups. Questions requested information on patient population, screening, counseling, prescribing practices, and practice resources. Data were analyzed using frequencies and questions were grouped thematically. Recommendations were delivered to the practice group. Results: 17/46 providers (37%) and five of seven practice managers (71%) responded. 35%(n=17) of PCPs reported that their clinics never provide support for contraceptive counseling training (p<0.05). 6%(n=17) of practitioners report that reproductive intent screening is integrated into the electronic health record (p<0.05). Responses were compared to guidelines. Recommendations were made to the practice group. Conclusion: This project can inform future policy and clinical education initiatives. Practices can enhance contraceptive care outside of the women’s health setting, increasing access and decreasing barriers for those at risk of unintended pregnancy.
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Date
2020-01-01