Intrauterine Contraception: Knowledge and Prescribing Practices of Canadian Health Care Providers

J Obstet Gynaecol Can. 2019 Aug;41(8):1084-1092. doi: 10.1016/j.jogc.2018.11.027. Epub 2019 Mar 18.

Abstract

Objective: Contraception is an important issue in the lives of women, their partners, and society. Canadians and their health care providers play a critical role in contraceptive decision making that influences individuals and Canadian society. The purpose of this study was to gather data on contraception-related knowledge, counselling, and prescribing practices of Canadian health care providers.

Methods: This project reported on the outcomes of an educational initiative, designed as a quality improvement initiative (time series level II-3), focused on Canadian health care providers' contraception-related knowledge, counselling, and prescribing practices. Outcomes were intended to inform the development of tools, resources, and educational programming. Part 1 was an online program to identify educational and knowledge gaps for health care providers. Part 2 was a practice assessment exploring and measuring health care providers' contraceptive counselling and prescribing practices.

Results: A total of 4300 health care providers completed the program between July 6, 2015 and August 30, 2016. Knowledge significantly increased; post-test scores were higher than pretest scores. After completion, all participants felt more comfortable, knowledgeable, and inclined to change their practice around prescribing intrauterine contraception (IUC). The 4300 providers reported on their contraception counselling experiences with 10 patients following participation in Part 1. Forty percent of patients were using oral contraceptives, and 53% were dissatisfied with their current type of contraception. After counselling, patients reported being most comfortable with IUC (55%). Both short- and long-acting types of contraception were most often discussed or offered (74% of the time), followed by long-acting reversible contraception only (21%) and short-acting methods only (5%).

Conclusion: This training program filled an education need for patients and gave providers tools to change their behaviour and practice around IUC prescribing. On the basis of these data, a practice assessment model was deemed a successful way to change behaviour.

Keywords: Contraception; counselling; intrauterine contraception; intrauterine device.

MeSH terms

  • Canada
  • Counseling / standards
  • Education, Distance / standards*
  • Family Planning Services / standards
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Personnel / education*
  • Humans
  • Intrauterine Devices*
  • Patient Education as Topic
  • Prescriptions
  • Primary Health Care / standards
  • Program Evaluation
  • Quality Improvement