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A study of physician recommendations for reversible contraceptive methods using standardized patients
Christine Dehlendorf1, Kevin Grumbach, Eric Vittinghoff
1Department of Family and Community Medicine, University of California, San Francisco, CA, USA. cdehlendorf@fcm.ucsf.edu
Perspectives on Sexual and Reproductive Health
|December 14, 2011
Summary
Physician characteristics influence contraceptive recommendations, with the pill and ring most frequently advised. Patient advice on contraception may differ based on provider demographics, necessitating further research into these variations.
Area of Science:
- Reproductive Health
- Medical Education
- Health Services Research
Background:
- Healthcare providers significantly impact patient contraceptive choices.
- Limited understanding exists regarding specific contraceptive method recommendations made by providers.
Purpose of the Study:
- To investigate how physician characteristics are associated with recommendations for various contraceptive methods.
- To identify potential disparities in contraceptive advice based on provider demographics and practice types.
Main Methods:
- 468 physicians from family medicine and obstetrics/gynecology meetings viewed standardized patient videos differing in race, socioeconomic status, and gynecologic history.
- Physicians reported their demographic and practice characteristics and contraceptive recommendations.
- Multivariate logistic regression analyzed associations between physician factors and method recommendations.
Main Results:
- The pill (89%) and ring (80%) were most recommended, followed by levonorgestrel IUD (64%).
- Private practice physicians were more likely to recommend oral contraceptives (OR, 2.9).
- Recommendations for the ring, patch, and injectable varied by physician specialty and age, with IUDs less recommended by older physicians.
Conclusions:
- Contraceptive advice provided to patients can vary based on healthcare provider characteristics.
- Further research is required to understand the underlying reasons for these observed differences in recommendations.
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