Dr Shu Ling Fan1, Dr Dinglin 'Lily' Gu2, Dr Suet-Wan Choy1,3, Dr Amy Crosthwaite1,3, Dr Vanessa Heron1,3, Dr Kathy Paizis1,3
1MERCY HOSPITAL FOR WOMEN, Heidelberg, Australia, 2The University of Melbourne, Parkville, Australia, 3Austin Hospital, Heidelberg, Australia
Biography:
Biographies to come
Abstract:
Aim: To assess clinician knowledge and current practices in contraception counselling for women of childbearing age who are prescribed teratogenic medications, and identify barriers to effective family planning discussions.
Background: Multiple medical conditions that are common in childbearing years may require the use of teratogenic medications. Unplanned pregnancy can be detrimental to maternal and foetal wellbeing, therefore effective contraception counselling is essential.
Methods: A single centre, observational, cross-sectional survey of women of childbearing age who are taking teratogenic medications, and the clinicians who prescribe these medications.
Results: Of the 16 women surveyed, 4/16 reported not being told about the safety of their medications during a potential pregnancy. Just 5/16 reported using long-acting reversible contraception. 9/16 patients had never received any contraception advice from their clinicians, and only 3 patients had accessed online resources about contraception.
32 clinicians across multiple medical specialities were included. Most correctly identified the teratogenicity of methotrexate (30/32), mycophenolate (27/32), and warfarin (26/32). Only 17/32 reported consistently discussing contraception when starting teratogenic medications for all patients. A minority felt very confident with providing contraception counselling (2/32), most clinicians felt somewhat confident (16/32), some felt uncomfortable (12/32), or very uncomfortable (2/32). The most commonly reported barrier to delivering contraceptive counselling was time constraint in 21/32, lack of familiarity with available resources in 17/32, lack of training in 15/32, and considering this outside the clinical scope of the specialist in 12/32.
Conclusion: There is a low rate of contraception discussions for women of childbearing age who have been prescribed teratogenic medications. A substantial proportion of clinicians lack the confidence to effectively undergo family planning discussions. This survey is ongoing and improvement in education and awareness will be sought at training college and institutional levels.
Keywords
contraception, teratogenic medications, survey