Physician awareness regarding contraceptive counselling in women with chronic disease

Abstract

Introduction

Contraceptive counselling is essential in women with chronic disease, though it is frequently overlooked. We aimed to assess practices and awareness in contraceptive counselling in hospital physicians caring for reproductive age women with chronic disease.

Methods

A questionnaire was distributed in April 2017 to physicians from 16 medical specialties in a tertiary care hospital in Portugal. Statistical analysis performed using Microsoft Office Excel^® and IBM SPSS-Statistics^®.

Results

Two-hundred physicians participated in the survey: 59.5% were female, 55% under 35 years-old and 48.5% were residents. Only 26.5% practiced in surgical specialties. Two-thirds consistently inquired about the use of contraception. Most referred patients to Family Planning services or performed contraceptive counselling when pregnancy posed significant health risks (89.0%), when prescribing teratogenic medication (79.5%) or drugs with potential interaction with contraceptives (75.0%). Lack of training in contraception was the main reason for not referring patients to Family Planning services. While 83% considered counselling very important, only 5% had recently undergone training and 12.5% felt knowledgeable enough to perform it. Only 12.5% were aware of the institution’s Family Planning resources. Female gender, non-surgical specialty, age over 35 years-old and over 10 years since specialisation were positively associated with awareness.

Conclusion

Most physicians addressed contraceptive management in women with comorbidities, but adequate training is lacking. Our results highlight the importance of communication between health care providers to achieve an adequate and multidisciplinary approach to reproductive and general health goals.

摘要

简介：避孕咨询对于患有慢性疾病的女性来说是必不可少的, 尽管它经常被忽视。我们旨在评估照顾患有慢性病的育龄妇女的医院医生在避孕咨询方面的做法和意识。

方法：2017年4月在葡萄牙的一家三级医院向16个临床科室的医师发放问卷, 使用 Microsoft Office ExcelVR和 IBM SPSS-StatisticsVR进行统计分析。

结果：200名医生参与了调查, 其中女性占59.5%, 35岁以下占55%, 住院医师占48.5%。只有 26.5% 的人从事外科专业。三分之二的人一直询问避孕的使用情况。大多数将患者转诊到计划生育服务或在怀孕带来重大健康风险时 (89.0%)、在开具致畸药物 (79.5%) 或与避孕药具潜在相互作用的药物 (75.0%) 时进行避孕咨询。缺乏避孕知识培训是未将患者转诊至计划生育服务的主要原因。虽然 83% 的人认为咨询非常重要, 但只有 5% 的人最近接受过培训, 12.5% 的人认为有足够的知识来执行它。只有 12.5% 的人知道有该科室的计划生育资源。女性、非外科专业、年龄超过35岁和执业超过 10 年与避孕认知呈正相关。

结论：大多数医生针对有合并症的女性进行避孕管理, 但缺乏足够的培训。我们的结果强调了医疗保健提供者之间沟通的重要性, 以实现生殖和一般健康目标的充分和多学科诊疗。

Keywords:

• Contraception
• family planning services
• morbidity
• health knowledge
• attitudes
• practice

Acknowledgements

The authors would like to thank all physicians from Coimbra Hospital and University Centre who participated in this survey.

Disclosure statement

No potential conflict of interest was reported by the author(s).