Providing contraception for women taking potentially teratogenic medications

A survey of internal medicine physicians' knowledge, attitudes and barriers

David L. Eisenberg, Catherine Stika, Ami Desai, David Baker, Kathleen J Yost

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: The majority of women prescribed category D or X medications may not receive adequate contraceptive counseling or a reliable contraceptive method. Physicians who prescribe potentially teratogenic medications have a responsibility to provide women with contraceptive counseling, a method of highly-effective contraception, or both. Objective: Investigate the knowledge, beliefs and barriers of primary care physicians toward providing adequate contraception to women taking potential teratogens. Design& Participants: Self-administered confidential survey of primary care internal medicine physicians at an urban, academic medical center. Measurements: Knowledge of potential teratogenic medications and contraceptive failure rates was assessed. Participants' beliefs about adequacy of their medical education, practice limitations and attitudes toward improving provision of contraception to women on potential teratogens were assessed. Results: One hundred and ten physicians responded (57.3%). Nearly two-thirds (62.3%) of participants had cared for reproductive aged women taking category D or X medications in the past year. The mean percent of correctly identified category D or X medications was 58.4% (SD 22.1%). The mean percent correct for knowledge of published contraceptive failure rates was 64.6% (SD 23.1%). Most respondents (87.6%) felt it is the responsibility of primary care physicians to provide contraception. Time constraints were reported to be somewhat or very limiting by 61.3% and over half felt medical school (63.2%) or residency (58.1%) inadequately prepared them to prescribe or counsel about contraceptives. Conclusions: Primary care physicians commonly encounter reproductive age women taking category D or X medications, but may lack sufficient knowledge and time to counsel about potential teratogens and contraception to prevent fetal exposure to these drugs.

Original languageEnglish (US)
Pages (from-to)291-297
Number of pages7
JournalJournal of General Internal Medicine
Volume25
Issue number4
DOIs
StatePublished - Apr 2010

Fingerprint

Internal Medicine
Contraception
Contraceptive Agents
Physicians
Teratogens
Primary Care Physicians
Counseling
Internship and Residency
Medical Education
Medical Schools
Surveys and Questionnaires
Primary Health Care
Pharmaceutical Preparations

Keywords

  • Adult
  • Contraception
  • Counseling
  • Female
  • Humans
  • Physician behavior
  • Physician practice patterns
  • Pregnancy
  • Prescription drugs
  • Primary care
  • Survey
  • Teratogens
  • Women's health

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Providing contraception for women taking potentially teratogenic medications : A survey of internal medicine physicians' knowledge, attitudes and barriers. / Eisenberg, David L.; Stika, Catherine; Desai, Ami; Baker, David; Yost, Kathleen J.

In: Journal of General Internal Medicine, Vol. 25, No. 4, 04.2010, p. 291-297.

Research output: Contribution to journalArticle

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abstract = "Background: The majority of women prescribed category D or X medications may not receive adequate contraceptive counseling or a reliable contraceptive method. Physicians who prescribe potentially teratogenic medications have a responsibility to provide women with contraceptive counseling, a method of highly-effective contraception, or both. Objective: Investigate the knowledge, beliefs and barriers of primary care physicians toward providing adequate contraception to women taking potential teratogens. Design& Participants: Self-administered confidential survey of primary care internal medicine physicians at an urban, academic medical center. Measurements: Knowledge of potential teratogenic medications and contraceptive failure rates was assessed. Participants' beliefs about adequacy of their medical education, practice limitations and attitudes toward improving provision of contraception to women on potential teratogens were assessed. Results: One hundred and ten physicians responded (57.3{\%}). Nearly two-thirds (62.3{\%}) of participants had cared for reproductive aged women taking category D or X medications in the past year. The mean percent of correctly identified category D or X medications was 58.4{\%} (SD 22.1{\%}). The mean percent correct for knowledge of published contraceptive failure rates was 64.6{\%} (SD 23.1{\%}). Most respondents (87.6{\%}) felt it is the responsibility of primary care physicians to provide contraception. Time constraints were reported to be somewhat or very limiting by 61.3{\%} and over half felt medical school (63.2{\%}) or residency (58.1{\%}) inadequately prepared them to prescribe or counsel about contraceptives. Conclusions: Primary care physicians commonly encounter reproductive age women taking category D or X medications, but may lack sufficient knowledge and time to counsel about potential teratogens and contraception to prevent fetal exposure to these drugs.",
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