Barriers and facilitators to the delivery and uptake of long-acting reversible contraception
What are the views of general practitioners?
Chief Investigator: Professor Danielle Mazza, Department of General Practice, Monash University
Unintended pregnancies have long been identified as a significant public health problem both in Australia and internationally. In Australia, around 51% of women have experienced an unintended pregnancy in their lifetime  and, according to US data, about half of these end in abortion . While there is strong evidence that the increased use of long-acting reversible contraceptives (LARCs; eg, intrauterine devices and implants) has the potential to reduce unintended pregnancy and abortion rates, only 3-5% of Australian women who are at risk of pregnancy use LARCs [3,4].
In Australia, general practice is the “first line” in the delivery of contraception to women and the management of sexual and reproductive health concerns. General practitioners (GPs) therefore play a central role in the delivery of contraception to Australian women and their views on contraception can influence the type of advice that they provide and the type of contraception used by patients [5-7]. However, little is known about the views of Australian GPs in relation to promoting the use of LARCs among women who are at risk of pregnancy. Recent analysis of Australian general practice consultations using data from the Bettering the Evaluation and Care of Health (BEACH) program indicate that only 6.9% of all contraception consultations involve LARCs .
Researchers at the Department of General Practice, Monash University, are investigating the reasons for the inadequate delivery and uptake of LARCs among women who attend general practices. The team have recruited GPs from around Australia to participate in semi-structured telephone interviews. Results from this study will identify key barriers and facilitators to the uptake of LARCs in the general practice setting and will inform the development of interventions tailored to close the evidence-practice gap.
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- Gray E, McDonald P. Using a reproductive life course approach to understand contraceptive method use in Australia. J Biosoc Sci. 2010;42(1):43-57.
- Richters J, Grulich AE, de Visser RO, et al. Sex in Australia: contraceptive practices among a representative sample of women. Aust N Z J Public Health. 2003;27(2):210-6.
- Middleton AJ, Naish J, Singer N. General practitioners' views on the use of the levonorgestrel-releasing intrauterine system in young, nulligravid women, in London, UK. Eur J Contracept Reprod Health Care. 2011;16(4):311-8.
- National Collaborating Centre for Women’s and Children’s Health. Long-acting reversible contraception: The effective and appropriate use of long-acting reversible contraception. London: RCOG Press; 2005.
- Wellings K, Zhihong Z, Krentel A, et al. Attitudes towards long-acting reversible methods of contraception in general practice in the UK. Contraception. 2007;76(3):208-14.
- Mazza D, Harrison C, Taft A, et al. Current contraceptive management in Australian general practice: an analysis of BEACH data. Med J Aust. 2012;197(2):110-4.