Current contraceptive management in Australian general practice: an analysis of BEACH data

Abstract

Objective: To determine current contraceptive management by general practitioners in Australia. Design, setting and participants: Analysis of data from a random sample of 3910 Australian GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) survey, a continuous cross‐sectional survey of GP activity, between April 2007 and March 2011. Consultations with female patients aged 12–54 years that involved all forms of contraception were analysed. Main outcome measures: GP and patient characteristics associated with the management of contraception; types of contraception used; rates of encounters involving emergency contraception. Results: Increased age, ethnicity, Indigenous status and holding a Commonwealth Health Care Card were significantly associated with low rates of encounters involving management of contraception. The combined oral contraceptive pill was the most frequently prescribed method of contraception, with moderate prescription of long‐acting reversible contraception (LARC), especially among women aged 34–54 years. Rates of consultations concerned with emergency contraception were low, but involved high rates of counselling, advice or education (48%) compared with encounters for general contraception (> 20%). Conclusion: A shift towards prescribing LARC, as recommended in clinical guidelines, has yet to occur in Australian general practice. Better understanding of patient and GP perspectives on contraceptive choices could lead to more effective contraceptive use.

Preconception care for women with type 2 diabetes mellitus: A mixed-methods study of provider knowledge and practice

“…These findings concur with previous reports of high proportions of unplanned pregnancy (>50%) generally in Australia [38], and limited presentation for preconception care despite primary health care practitioners seeing this setting as ideal to provide preconception care [26] [27].…”

Prevalence and distribution of unintended pregnancy: the Understanding Fertility Management in Australia National Survey

“…Recent Australian research suggests that health service inequalities are likely to be implicated. Mazza and colleagues 25 analysed data about consultations with female patients aged 12-54 years that involved all forms of contraception from a random sample of 3,910 Australian GPs between April 2007 and March 2011. Increased age, non-English speaking background, Indigenous status and holding a Commonwealth Health Care Card were significantly associated with low rates of GP encounters involving management of contraception.…”

A prospective cohort study of early postpartum etonogestrel implant (Implanon®) use and its effect on duration of lochia

“…The trend towards increased use of LARC, especially in younger women, has been supported by published data 4 6. Studies also show a reduction in repeat pregnancy in adolescents with the immediate postpartum use of Implanon 7 8.…”

“…A recent Australian study showed low rates of use of Implanon specifically, with a reported use of 4.9 per 100 contraception problems managed in a general practice setting 4. Clinical guidelines in the UK state that Implanon can be used “at any time postpartum” 5.…”