1. Requesting early removal of long-acting reversible contraception: a qualitative study exploring the experiences of doctors working in primary care.
- Author
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Ding, Jacqueline, Williams, Henrietta, Hocking, Jane S., and Coombe, Jacqueline
- Subjects
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LONG-acting reversible contraceptives , *CONTRACEPTION , *MEDICAL device removal , *PATIENT autonomy , *PHYSICIAN-patient relations , *RESEARCH methodology , *PHYSICIANS' attitudes , *INTERVIEWING , *PRIMARY health care , *QUALITATIVE research , *CONFLICT (Psychology) , *DESCRIPTIVE statistics , *PHYSICIANS , *STATISTICAL sampling , *THEMATIC analysis , *DATA analysis software - Abstract
Long-acting reversible contraceptives (LARC) are the most effective contraceptive methods available in Australia and are effective for between 3 and 8 years. Early LARC removal (<12 months of use) can lead to gaps in contraceptive cover, exposing women to the risk of unplanned pregnancy. This study explored the experiences of doctors working in primary care (GPs and sexual health physicians) when asked to remove LARC earlier than expected. From May to July 2020, 13 doctors in Melbourne, Australia, were interviewed. Overall, participants felt conflicted about early LARC removal requests; participants highlighted the importance of respecting patient autonomy, but many felt that patients should ideally persist with LARC longer. Participants found balancing a desire to respect patients' autonomy with their clinical responsibility challenging. Doctors used reassurance, delaying tactics and treatment of side effects to try and prolong LARC use. However, this balancing act led many doctors to perceive a tension between themselves and their patients when early LARC removal was requested. Incorporating professional education addressing these issues may help primary care providers better anticipate and navigate the tension surrounding early LARC removal consultations and maintain effective doctor–patient relationships. Long-acting reversible contraception (LARC) are the most effective contraceptive methods available, and although most women keep their LARC in for the prescribed length of time, others will request early removal. This study found a perceived tension between doctors and their patients when early LARC removal was requested. Appropriate training and more relevant professional development may help primary care providers better navigate the tension surrounding early LARC removal consultations and maintain effective doctor–patient relationships. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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