Attitudes towards long-acting reversible methods of contraception in general practice in the UK.
BACKGROUND
Recently published national guidance in England recommended that increased use of long-acting reversible methods of contraception could reduce unintended pregnancy rates. Usage rates of long-acting reversible methods of contraception in the UK are currently low. Since these methods require medical intervention, attitudes of professionals are important determinants of prevalence of use.


METHODS
A questionnaire survey was conducted of 321 health professionals working in general practice which sought practitioner views on safety, efficacy and acceptability of contraceptive methods, and on the feasibility and desirability of prescribing long-acting methods.


RESULTS
A high proportion of practitioners (80.2%) endorsed the role of LARC in preventing teenage pregnancy, but fewer than half (47.1%) saw them as returning to favor. The combined oral contraceptive pill is still the mainstay of prescriptions. Lack of skill in providing was seen by 60.6% as a barrier to provision of long-acting methods of contraception. Half of respondents (50.3%) thought that irregular bleeding deterred women from using LARC and 20.6% were concerned about high discontinuation rates. Misconceptions about side effects of contraceptive methods were common.


CONCLUSIONS
Investment in professional education and training is needed for health professionals in general practice if the goal of increased provision of long-acting contraceptive methods is to be realized.
Wellings
Kaye
K
London School of Hygiene and Tropical Medicine, London, England, WC1E 7HT, UK. kaye.wellings@lshtm.ac.uk
Zhihong
Zhang
Z
Krentel
Alison
A
Barrett
Geraldine
G
Glasier
Anna
A
D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003267:Contraception / Q000379:methods* / Q000706:statistics & numerical data; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D004343:Drug Implants; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007273:Injections, Intramuscular; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D013997:Time Factors; D006113:United Kingdom
D003271:Contraceptive Agents, Female; D004343:Drug Implants