Dr Abhishikta Dey1,2, Dr Geraldine Hassett3,4, Dr Katherine Poulsen5,6,7, Prof Natasha Nassar2, Dr Antonia Shand2,8
1Royal Prince Alfred Hospital, Camperdown, Australia, 2Child Population and Translational Health Research, Children’s Hospital at Westmead Clinical School and Menzies Centre for Health Policy and Economics, University of Sydney, Camperdown, Australia, 3Liverpool Hospital, Liverpool, Australia, 4School of Clinical Medicine, UNSW Medicine and Health, , Liverpool, Australia, 5University of Queensland, Chermside, Australia, 6Prince Charles Hospital, Chermside, Australia, 7Royal Brisbane and Women's Hospital , Brisbane, Australia, 8Royal Hospital for Women, Randwick, Australia
Biography:
Biographies to come
Abstract:
Aim: Rheumatic diseases require management with disease modifying antirheumatic drugs (DMARDs). Some DMARDS are teratogenic and/or may not be used during lactation. Contraception is an important issue in reproductive aged women. The literature suggests use of highly effective contraception in women with rheumatic disease is low. Few studies have investigated prescribing practices of contraception by rheumatologists. We aimed to assess the practice and attitudes of Australian and New Zealand rheumatologists and rheumatology trainees regarding prescribing contraception among reproductive-aged women with rheumatic diseases.
Method: An online questionnaire was distributed in October 2023 to rheumatologists in Australia and New Zealand with ongoing recruitment. Demographic characteristics and specific questions about contraception prescribing behaviours towards reproductive-aged women and attitudes towards involvement with family planning and pregnancy were collected.
Results: Ninety-one people responded (18.6% trainees, 27.9% <5 years, 17.4% 5-9 years, 12.8% 10-19 years and 23.3% 20+ years post specialist qualification of practice). All participants had prescribed a DMARD. Two thirds of participants did not believe rheumatologists should prescribe contraception (69.4%). One-third (33.8%) had experienced women of child-bearing age having unplanned pregnancies. Two-thirds (68.2%) of rheumatologists would consider using a text tool in their letters to guide general practitioners (GPs) on contraception prescribing for patients of reproductive age with rheumatic diseases.
Conclusion: Rheumatologists and rheumatology trainees do not routinely prescribe contraception. A text tool providing guidance around contraception prescription from rheumatologists to GPs may increase the uptake of contraception and reduce unplanned pregnancies in women with rheumatic diseases. A future study to understand GPs prescribing practices will be important when developing this tool.
Keywords
Rheumatology, DMARDs, contraception