Missed opportunities in contraceptive counselling: findings from a European survey-based study with simulated patient consultation.

Autor: Nappi RE; Research Centre for Reproductive Medicine, Gynaecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy., Vermuyten N; Women's Health, Bayer, Berlin, Germany., Bannemerschult R; Women's Health, Bayer, Berlin, Germany.
Jazyk: angličtina
Zdroj: The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception [Eur J Contracept Reprod Health Care] 2022 Apr; Vol. 27 (2), pp. 85-94. Date of Electronic Publication: 2021 Dec 03.
DOI: 10.1080/13625187.2021.2010040
Abstrakt: Purpose: Available evidence highlights unmet needs in contraceptive counselling practices. This study aimed to understand current practises and clinician behaviour across Europe.
Methods: A novel, online approach was used to simulate contraceptive counselling discussions based on three, predefined patient types with a hidden need: poor compliance (patient X), headaches (Y) or desire for a hormone-free option (Z). Clinicians were asked to provide guidance about a contraceptive method for their randomly assigned patient at two time points: (1) after a simulated discussion, (2) after seeing a full patient profile. Descriptive statistical analyses included evaluation of the clinicians' counselling approach and a change in contraceptive recommendation thereof.
Results: Out of 661 clinicians from 10 participating European countries, including obstetricians/gynaecologists, midwives and general practitioners, most failed to uncover patient X and Y's hidden needs (78.8% and 70.5%, respectively), whereas, 63.4% of clinicians uncovered patient Z's hidden need. Clinicians who uncovered their patients' hidden needs asked significantly more questions than those who did not (range of mean, 5.1-7.8 vs 1.5-2.2 respectively). Clinicians were more likely to recommend a change of prescription after seeing the full patient profile than after the simulated discussion (increase in prescription change, range: 12.3-30.2%), indicating that clinicians rely on patients speaking up proactively about any concerns.
Conclusions: Insufficient existing counselling practices result in missed opportunities for shared decision-making and discussion. Clinicians and contraceptive counselling services should empower women by introducing more in-depth contraceptive counselling, incorporating clear, open-ended questions, to improve patient adherence and enhance reproductive planning.
Databáze: MEDLINE
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