Associations of anticipated prescribing of long-acting reversible contraception by general practice registrars: A cross-sectional study.

Abstract

Long-acting reversible contraception (LARC) is highly effective, but uptake in Australia is low. The aim of this study was to establish general practice registrars' LARC training/insertion experience, as well as frequency of and factors associated with choosing LARC in response to clinical vignettes. This was a cross-sectional questionnaire-based study of general practice registrars inNSW or ACT. The questionnaire elicited acontraceptive management response to three clinical vignettes. The outcome factor in each of three multivariate logistic regression analyses was: 'LARC chosen' or'LARC not chosen'. Of 223 registrars, 18.5% had received intrauterine device (IUD) insertion training, and 9.4% had inserted IUD in general practice. For contraceptive implants, these figures were 64.3% for training and 50.3% for insertion. Significant multivariate associations (all odds ratios >2.5) of choosing LARC in at least one vignette included Australian medical graduate, female gender and confidence in knowledgeregarding IUD/implant. Modest proportions of general practice registrars have training in, and in-practice experience of, LARC insertion. The most notable association with choice of LARC was confidence in knowledge regarding LARC.