Monash University, Melbourne, VIC, Australia.
Family Medicine Research Centre, University of Sydney, Sydney, NSW, Australia.
Med J Aust. 2014 Apr 21;200(7):414-5. doi: 10.5694/mja13.10983.
To determine long-term trends in emergency contraception (EC) management by general practitioners in Australia.
DESIGN, SETTING AND PARTICIPANTS: Data from April 2000 to March 2012 were drawn from the BEACH (Bettering the Evaluation and Care of Health) program, a continuous cross-sectional survey of GP activity. We analysed consultations involving EC management, unwanted pregnancy management and emergency contraceptive pill (ECP) prescribing per 1000 GP encounters with women aged 14-54 years. Summary statistics were calculated with 95% confidence intervals.
In 2000-2001, GPs managed EC problems at a rate of 5.50 per 1000 encounters (95% CI, 4.37-6.63). From 2004, after the ECP became available over the counter (OTC) in pharmacies, EC management, which includes ECP prescription, progressively declined. By 2011-2012, only 1.43 EC problems were managed per 1000 encounters (95% CI, 0.84-2.02) and only 0.48 ECP prescriptions were provided per 1000 encounters (95% CI, 0.14-0.82). Yet the management rate of unwanted pregnancy problems stayed relatively constant (rate in 2000-2001, 0.95 per 1000 encounters; 95% CI, 0.40-1.50; rate in 2011-2012, 0.88 per 1000 encounters; 95% CI, 0.41-1.36).
Low rates of EC management by GPs since ECP became available OTC suggest that women may be obtaining information on EC elsewhere. Further investigation is needed to uncover the sources of this information and its acceptability and application by Australian women.
确定澳大利亚全科医生在紧急避孕（EC）管理方面的长期趋势。
设计、地点和参与者：数据来自 2000 年 4 月至 2012 年 3 月的 BEACH（改善健康评估和护理）项目，这是一项针对全科医生活动的连续横断面调查。我们分析了涉及 EC 管理、意外怀孕管理和紧急避孕丸（ECP）处方的每 1000 次与 14-54 岁女性的 GP 就诊。使用 95%置信区间计算汇总统计数据。
在 2000-2001 年，GP 处理 EC 问题的速度为每 1000 次就诊 5.50 次（95%CI，4.37-6.63）。自 2004 年 ECP 在药房非处方供应以来，EC 管理（包括 ECP 处方）逐渐下降。到 2011-2012 年，每 1000 次就诊仅管理 1.43 个 EC 问题（95%CI，0.84-2.02），每 1000 次就诊仅提供 0.48 个 ECP 处方（95%CI，0.14-0.82）。然而，意外怀孕问题的管理率保持相对稳定（2000-2001 年的发生率为每 1000 次就诊 0.95 次；95%CI，0.40-1.50；2011-2012 年的发生率为每 1000 次就诊 0.88 次；95%CI，0.41-1.36）。
自 ECP 非处方供应以来，GP 对 EC 的管理率较低，这表明女性可能在其他地方获得有关 EC 的信息。需要进一步调查以揭示这些信息的来源及其在澳大利亚女性中的可接受性和应用。
