School of Medicine and Health Sciences Poster Presentations

Title

Acute Care Long Acting Reversible Contraceptive Placement: A Compare and Contrast Study

Poster Number

339

Document Type

Poster

Status

Medical Student

Abstract Category

Women/Child Health

Keywords

contraception, emergency department, womens health, process improvement

Publication Date

Spring 2018

Abstract

Background: Improving access to effective contraception and reducing rates of unintended pregnancy are national public health objectives. Long Acting Reversible Contraceptives (LARCs) are safe, well tolerated and the most effective means of reversible contraception. Unfortunately, the requisite clinical pathway leading to LARC placement can dissuade women from obtaining care, as this process is often unfamiliar, time-consuming and expensive. LARC counseling and placement in the Acute Care setting is a novel strategy intended to minimize these logistical barriers. In the present study, we hypothesize that women will express interest in an Acute Care based LARC placement program and that an “expedited referral to a Gynecologist” (ERG) will fail to capture a significant proportion of women interested in obtaining a LARC.

Methods: This study consists of a 21-question cross-sectional survey, a brief contraceptive counseling video (BCCV) and an optional ERG for contraceptive counseling and placement. A convenience sample of women ages of 18 and 50 were approached at a freestanding urgent care center (UC) (N=146) and an emergency department based urgent care center (ED) (N=144). The study was powered to an N of 288 participants and data analysis completed with chi-squared and t-tests.

Results: Of 439 women approached, 290 (66%) met eligibility criteria and enrolled. 152 participants (52%) reported using their preferred method of contraception. This number decreased to 117 (40%) after viewing the BCCV. 154 (53%) of participants expressed interest in returning to an Acute Care setting for LARC placement. Only 28 of the 114 (25%) participants requesting ERG scheduled a visit when contacted by an office manager. There was no statistical difference regarding responses recorded at the ED vs. UC.

Conclusion: Nearly half of reproductive age women presenting to the ED and UC are not using their preferred method of contraception. Most women felt comfortable discussing contraception in the Acute Care setting and many expressed interest in an Acute Care based LARC placement program. Moreover, an ERG program failed to link a significant proportion of women interested in obtaining a LARC to care. Acute Care LARC counseling and placement is a novel and potentially viable strategy to supplement existing healthcare infrastructure and improve access to effective contraception.

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Acute Care Long Acting Reversible Contraceptive Placement: A Compare and Contrast Study

Background: Improving access to effective contraception and reducing rates of unintended pregnancy are national public health objectives. Long Acting Reversible Contraceptives (LARCs) are safe, well tolerated and the most effective means of reversible contraception. Unfortunately, the requisite clinical pathway leading to LARC placement can dissuade women from obtaining care, as this process is often unfamiliar, time-consuming and expensive. LARC counseling and placement in the Acute Care setting is a novel strategy intended to minimize these logistical barriers. In the present study, we hypothesize that women will express interest in an Acute Care based LARC placement program and that an “expedited referral to a Gynecologist” (ERG) will fail to capture a significant proportion of women interested in obtaining a LARC.

Methods: This study consists of a 21-question cross-sectional survey, a brief contraceptive counseling video (BCCV) and an optional ERG for contraceptive counseling and placement. A convenience sample of women ages of 18 and 50 were approached at a freestanding urgent care center (UC) (N=146) and an emergency department based urgent care center (ED) (N=144). The study was powered to an N of 288 participants and data analysis completed with chi-squared and t-tests.

Results: Of 439 women approached, 290 (66%) met eligibility criteria and enrolled. 152 participants (52%) reported using their preferred method of contraception. This number decreased to 117 (40%) after viewing the BCCV. 154 (53%) of participants expressed interest in returning to an Acute Care setting for LARC placement. Only 28 of the 114 (25%) participants requesting ERG scheduled a visit when contacted by an office manager. There was no statistical difference regarding responses recorded at the ED vs. UC.

Conclusion: Nearly half of reproductive age women presenting to the ED and UC are not using their preferred method of contraception. Most women felt comfortable discussing contraception in the Acute Care setting and many expressed interest in an Acute Care based LARC placement program. Moreover, an ERG program failed to link a significant proportion of women interested in obtaining a LARC to care. Acute Care LARC counseling and placement is a novel and potentially viable strategy to supplement existing healthcare infrastructure and improve access to effective contraception.