Provision of contraception: a survey among primary care physicians in Finland

Abstract Objective. To investigate self-reported practices of contraceptive provision among primary care physicians. Design. A cross-sectional questionnaire study. Setting. All community health centers (n = 63) in an university hospital area in Western Finland. Sample and methods. A total of 122 hea...

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Bibliographic Details
Published in:Acta obstetricia et gynecologica Scandinavica 2010-05, Vol.89 (5), p.636-645
Main Authors: Sannisto, Tuire, Kosunen, Elise
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Attitude of Health Personnel
Biological and medical sciences
Chi-Square Distribution
Contraception - standards
Contraception - utilization
Contraceptive Agents, Female - administration & dosage
Contraceptives, Oral, Hormonal - administration & dosage
Contraceptives, Oral, Hormonal - adverse effects
contraindications
Cross-Sectional Studies
Female
female contraception
Finland
Gynecology. Andrology. Obstetrics
Health Care Surveys
Humans
Intrauterine Devices - utilization
Male
Medical sciences
Middle Aged
physicians
Physicians, Family - statistics & numerical data
Practice Patterns, Physicians' - statistics & numerical data
Practice Patterns, Physicians' - trends
Practices
primary health care
Primary Health Care - statistics & numerical data
Primary Health Care - trends
Probability
Quality of Health Care
Risk Assessment
Surveys and Questionnaires
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Summary:Abstract Objective. To investigate self-reported practices of contraceptive provision among primary care physicians. Design. A cross-sectional questionnaire study. Setting. All community health centers (n = 63) in an university hospital area in Western Finland. Sample and methods. A total of 122 health center physicians involved in contraceptive counseling (CC) were invited to participate in self-administered survey. Data were obtained on initiation of contraceptive methods and the limits and contraindications applied when prescribing combined hormonal contraception (CHC), and they were assessed against Finnish and WHO guidelines. Main outcome measures. Distribution of initiated contraceptive methods and of examinations and tests included, application of limits and contraindications in relation to age, smoking, body mass index or weight, blood pressure (BP) and migraine with aura when prescribing CHC (combined oral contraceptives (COCs), vaginal ring and contraceptive patch). Results. Responded physicians (n = 83.68%) said they most frequently prescribed the COC pill. Progestin-only pills, levonorgestrel-releasing intrauterine system and copper-releasing intrauterine device were also provided regularly. Most of the respondents routinely took numerous examinations and tests when initiating contraception, including also unnecessary ones. There were gaps in their knowledge about the limits and contraindications for CHC. For example, 41% of the respondents did not recognize migraine with aura as a contraindication and only 19% reported applying the recommended BP limit of 140/90 mmHg. Conclusions. The range of contraceptives available and examinations and tests offered were comprehensive. However, the inadequate procedures regarding assessment of contraindications for CHC suggests that updating CC practices is challenging in primary care.
ISSN:0001-6349
1600-0412
DOI:10.3109/00016341003650020