Document Detail


Evidence-based IUD practice: family physicians and obstetrician-gynecologists.
MedLine Citation:
PMID:  23027156     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Family physicians and obstetrician-gynecologists provide much of contraceptive care in the United States and have a shared goal in preventing unintended pregnancy among patients. We assessed their competency to offer women contraceptives of the highest efficacy levels.
METHODS: We conducted a national probability survey of family physicians and obstetrician-gynecologists (n=1,192). We measured counseling and provision practices of intrauterine contraception and used multivariable regression analysis to evaluate the importance of evidence-based knowledge to contraceptive care.
RESULTS: Family physicians reported seeing fewer contraceptive patients per week than did obstetrician-gynecologists and were less likely to report sufficient time for counseling. While 95% of family physicians believed patients were receptive to learning about intrauterine contraception, fewer than half offered counseling or the method. Only half were trained to competence to offer intrauterine contraception, while virtually all obstetrician-gynecologists were. Both family physicians and obstetrician-gynecologists were unlikely to have adequate knowledge of the women who would be good candidates for intrauterine contraception-as gauged by the Centers for Disease Control and Prevention Medical Eligibility Criteria for contraception-and consequently did not offer the method to a wide range of eligible patients.
CONCLUSIONS: Most family physicians providing contraceptive care were not offering methods with top-tier effectiveness, although they reported interest in updating contraceptive skills through training. Obstetrician-gynecologists had technical skills to offer intrauterine contraception but still required education on patient selection. Greater hands-on training opportunities for family physicians, and complementary education on eligible method candidates for obstetrician-gynecologists, can increase access to intrauterine contraception by women seeking contraceptive care.
Authors:
Cynthia C Harper; Jillian T Henderson; Tina R Raine; Suzan Goodman; Philip D Darney; Kirsten M Thompson; Christine Dehlendorf; J Joseph Speidel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Family medicine     Volume:  44     ISSN:  1938-3800     ISO Abbreviation:  Fam Med     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-02     Completed Date:  2013-02-26     Revised Date:  2013-08-20    
Medline Journal Info:
Nlm Unique ID:  8306464     Medline TA:  Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  637-45     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Gynecology, and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco 94118, USA. harperc@obgyn.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Clinical Competence
Counseling / standards
Evidence-Based Practice*
Family Practice* / statistics & numerical data
Female
Gynecology* / statistics & numerical data
Health Care Surveys
Humans
Intrauterine Devices* / contraindications,  supply & distribution
Male
Middle Aged
Obstetrics* / statistics & numerical data
Regression Analysis
United States
Grant Support
ID/Acronym/Agency:
K24 HD057086/HD/NICHD NIH HHS; R01 HD046027/HD/NICHD NIH HHS
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