title: Emergency contraception: A multispecialty survey of clinician knowledge and practices.
abstract: OBJECTIVE
  To assess knowledge and provision of emergency contraception (EC), particularly the most effective methods.
  
  
  METHODS
  A web-based survey was distributed to a cross-sectional convenience sample of healthcare providers across specialties treating reproductive-aged women. The survey was sent to 3260 practicing physicians and advanced practice clinicians in 14 academic centers between February 2013 and April 2014. We analyzed responses by provider specialty using multivariable logistic regression.
  
  
  RESULTS
  The final sample included 1684 providers (response rate=51.7%). Ninety-five percent of the respondents had heard of levonorgestrel (LNG) EC. Among reproductive health specialists, 81% provide LNG EC in their practice, although only half (52%) had heard of ulipristal acetate (UPA) and very few provide it (14%). The majority in family medicine (69%) and emergency medicine (74%) provide LNG, in contrast to 42% of internists and 55% of pediatricians. However, the more effective methods [UPA and copper intrauterine device (IUD)] were little known and rarely provided outside of reproductive health specialties; 18% of internists and 14% of emergency medicine providers had heard of UPA and 4% provide it. Only 22% of emergency providers and 32% of pediatricians had heard of the copper IUD used as EC. Among reproductive health specialists, only 36% provide copper IUD as EC in their practice. Specialty, provider type and proportion of women of reproductive age in the practice were related to knowledge and provision of some forms of EC.
  
  
  CONCLUSIONS
  Awareness and provision of the most effective EC methods, UPA and the copper IUD (which are provider dependent), are substantially lower than for LNG EC, especially among providers who do not focus on reproductive health.
  
  
  CONCLUSIONS
  In our sample of 1684 healthcare providers from diverse specialties who treat reproductive-aged women, knowledge and provision of the most effective forms of EC (UPA and the copper IUD) are far lower than for LNG EC. Women should be offered the full range of EC methods.
authors.affiliation: Department of Internal Medicine and Primary Care Women's Health at the Cleveland Clinic, Cleveland, OH, USA. Electronic address: baturp@ccf.org.
authors.forename: Pelin
authors.initials: P
authors.lastname: Batur
authors.affiliation: Office of Population Research at Princeton University, Princeton, NJ, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Cleland
authors.affiliation: Department of Internal Medicine at the Louis Stokes Department of Veterans Affairs Medical Center Hospital of Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: McNamara
authors.affiliation: Department of Family Medicine and Community Health at Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Justine
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Family Medicine and Community Health at Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Pickle
mesh_terms: D001364:Awareness; D002983:Clinical Competence; D044363:Contraception, Postcoital; D004635:Emergency Medicine; D005194:Family Practice; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007435:Intrauterine Devices, Copper; D016912:Levonorgestrel; D008511:Medicine; D009649:Norpregnadienes; D010372:Pediatrics; D010818:Practice Patterns, Physicians'; D034121:Reproductive Health Services
chemical_list: D009649:Norpregnadienes; D016912:Levonorgestrel; C555622:ulipristal acetate
keywords: Copper IUD; Emergency contraception; Levonorgestrel; Ulipristal