MBBS, BSc (Hons), DFSRH, DCH, Academic GP Registrar, Discipline of General Practice, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW; Medical Educator, GP Synergy Research and Evaluation Unit, Mayfield West, NSW.
BBiomed (Hons), MMedStat, Statistician and Senior Research Officer, GP Synergy Research and Evaluation Unit, Mayfield West, NSW; Conjoint Fellow, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW.
Aust J Gen Pract. 2021 Dec;50(12):929-935. doi: 10.31128/AJGP-09-20-5657.
Long-acting reversible contraception (LARC) is highly effective, but uptake in Australia is low. The aim of this study was to establish general practice registrars' LARC training/insertion experience, as well as frequency of and factors associated with choosing LARC in response to clinical vignettes.
This was a cross-sectional questionnaire-based study of general practice registrars in NSW or ACT. The questionnaire elicited a contraceptive management response to three clinical vignettes. The outcome factor in each of three multivariate logistic regression analyses was: 'LARC chosen' or 'LARC not chosen'.
Of 223 registrars, 18.5% had received intrauterine device (IUD) insertion training, and 9.4% had inserted IUD in general practice. For contraceptive implants, these figures were 64.3% for training and 50.3% for insertion. Significant multivariate associations (all odds ratios >2.5) of choosing LARC in at least one vignette included Australian medical graduate, female gender and confidence in knowledge regarding IUD/implant.
Modest proportions of general practice registrars have training in, and in-practice experience of, LARC insertion. The most notable association with choice of LARC was confidence in knowledge regarding LARC.
长效可逆避孕（LARC）具有高度有效性，但在澳大利亚的使用率较低。本研究旨在确定全科住院医师的 LARC 培训/插入经验，以及根据临床病例选择 LARC 的频率和相关因素。
这是一项针对新南威尔士州或首都领地的全科住院医师的横断面问卷调查研究。该问卷针对三个临床病例征集了避孕管理的应对措施。在三个多变量逻辑回归分析中的每个分析中，结果因素都是：“选择 LARC”或“未选择 LARC”。
在 223 名住院医师中，18.5%接受过宫内节育器（IUD）插入培训，9.4%在全科实践中插入过 IUD。对于避孕植入物，这些数字分别为 64.3%的培训和 50.3%的植入。在至少一个病例中选择 LARC 的显著多变量关联（所有优势比>2.5）包括澳大利亚医学毕业生、女性性别以及对 IUD/植入物知识的信心。
少数全科住院医师接受过 LARC 插入方面的培训和实践经验。与选择 LARC 最相关的因素是对 LARC 知识的信心。
