Wellings Kaye, Zhihong Zhang, Krentel Alison, Barrett Geraldine, Glasier Anna
London School of Hygiene and Tropical Medicine, London, England, WC1E 7HT, UK.
Contraception. 2007 Sep;76(3):208-14. doi: 10.1016/j.contraception.2007.05.085. Epub 2007 Jul 26.
Recently published national guidance in England recommended that increased use of long-acting reversible methods of contraception could reduce unintended pregnancy rates. Usage rates of long-acting reversible methods of contraception in the UK are currently low. Since these methods require medical intervention, attitudes of professionals are important determinants of prevalence of use.
A questionnaire survey was conducted of 321 health professionals working in general practice which sought practitioner views on safety, efficacy and acceptability of contraceptive methods, and on the feasibility and desirability of prescribing long-acting methods.
A high proportion of practitioners (80.2%) endorsed the role of LARC in preventing teenage pregnancy, but fewer than half (47.1%) saw them as returning to favor. The combined oral contraceptive pill is still the mainstay of prescriptions. Lack of skill in providing was seen by 60.6% as a barrier to provision of long-acting methods of contraception. Half of respondents (50.3%) thought that irregular bleeding deterred women from using LARC and 20.6% were concerned about high discontinuation rates. Misconceptions about side effects of contraceptive methods were common.
Investment in professional education and training is needed for health professionals in general practice if the goal of increased provision of long-acting contraceptive methods is to be realized.
英国最近发布的国家指南建议,增加长效可逆避孕方法的使用可以降低意外怀孕率。目前,英国长效可逆避孕方法的使用率较低。由于这些方法需要医疗干预,专业人员的态度是使用普及率的重要决定因素。
对321名从事全科医疗工作的卫生专业人员进行了问卷调查,以了解从业者对避孕方法的安全性、有效性和可接受性,以及开具长效方法的可行性和可取性的看法。
很大比例的从业者(80.2%)认可长效可逆避孕法在预防青少年怀孕方面的作用,但不到一半(47.1%)的人认为它们再度受到青睐。复方口服避孕药仍然是处方的主要选择。60.6%的人认为缺乏提供长效避孕方法的技能是一个障碍。一半的受访者(50.3%)认为不规则出血阻碍了女性使用长效可逆避孕法,20.6%的人担心停用率高。对避孕方法副作用的误解很常见。
如果要实现增加长效避孕方法供应的目标,就需要对全科医疗的卫生专业人员进行专业教育和培训投资。