University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Chicago, IL, United States.
University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Women's Health Research and Innovation (CWHRI), University of Pittsburgh, Pittsburgh, PA,, United States.
Contraception. 2021 Oct;104(4):420-425. doi: 10.1016/j.contraception.2021.04.012. Epub 2021 Apr 22.
To better understand medication abortion attitudes and interest in future provision among Internal Medicine primary care providers (IM PCPs), and to characterize barriers to provision.
We conducted a survey with IM attendings and trainees at a large academic medical center in Western Pennsylvania. We used descriptive statistics to characterize attitudes towards medication abortion provision, including the belief that it is within their scope of practice and interest in future provision, and to explore perceived barriers to provision. We used logistic regression models to assess factors associated with each of these attitudes.
Of 397 eligible attendings and trainees, 121 (30%) completed the survey. Among those surveyed, 44% believed medication abortion is within the scope of practice of IM PCPs with trainees and female-identifying providers being significantly more likely to believe medication abortion is within their scope of practice compared to attending physicians and male physicians (60% vs 30%, p < 0.01 and 53% vs 31%, p = 0.01, respectively). Similarly, 43% endorsed interest in future provision, with trainees (67% vs 23%, p < 0.001) and female providers (54% vs 27%, p = 0.002) being more likely to express interest. The most cited barriers to provision included limited training in residency (70%) and low familiarity with abortion medications (57%).
Many IM providers- particularly trainees- believe medication abortion is within their scope of practice and would like to provide this care. Interventions are needed to provide education and assistance complying with state and federal regulations to enable safe and efficient medication abortion provision by IM providers.
IM departments and residency programs should seek to ensure training is offered to clinicians interested in providing medication abortion as a part of their primary care practice.
更好地了解内科初级保健提供者（IM PCP）对药物流产的态度和未来提供药物流产服务的意愿，并描述提供药物流产服务的障碍。
我们对宾夕法尼亚州西部一家大型学术医疗中心的内科主治医生和住院医师进行了一项调查。我们使用描述性统计来描述对药物流产服务的提供的态度，包括认为药物流产在他们的实践范围内，以及对未来提供药物流产服务的兴趣，并探讨提供药物流产服务的障碍。我们使用逻辑回归模型来评估与这些态度相关的因素。
在 397 名符合条件的主治医生和住院医师中，有 121 名（30%）完成了调查。在接受调查的人中，44%的人认为药物流产在 IM PCP 的实践范围内，而住院医师和女性身份的提供者比主治医生和男性医生更有可能认为药物流产在他们的实践范围内（60%比 30%，p < 0.01 和 53%比 31%，p = 0.01）。同样，43%的人表示对未来提供药物流产服务感兴趣，住院医师（67%比 23%，p < 0.001）和女性提供者（54%比 27%，p = 0.002）更有可能表达兴趣。提供药物流产服务的最大障碍包括在住院医师培训中药物流产培训有限（70%）和对堕胎药物的熟悉度低（57%）。
许多内科医生——特别是住院医师——认为药物流产在他们的实践范围内，并且愿意提供这种护理。需要采取干预措施，提供教育和协助遵守州和联邦法规，使内科医生能够安全有效地提供药物流产服务。
内科部门和住院医师项目应努力确保有兴趣将药物流产作为其初级保健实践一部分的临床医生接受培训。
