Anesthesia Providers' Knowledge of Medication Interference with Hormonal Contraception: A Multisite Survey

Area of Science:

• Pharmacology
• Anesthesiology
• Reproductive Health

Background:

• Sugammadex, aprepitant, and fosaprepitant are frequently used in perioperative settings.
• These medications possess the potential to reduce the efficacy of hormonal contraceptives (HCs).
• Assessing anesthesia providers' awareness and practices regarding these interactions is crucial for patient safety.

Purpose of the Study:

• To evaluate anesthesia providers' utilization of sugammadex and aprepitant.
• To determine providers' knowledge concerning drug interactions with hormonal contraceptives (HCs).
• To assess perioperative patient counseling practices related to these interactions and identify areas for educational improvement.

Main Methods:

• An electronic survey was administered to anesthesia providers across multiple Mayo Clinic sites in January 2023.
• The survey comprised 32 questions covering medication use, knowledge of HC interactions, training perceptions, and counseling habits.
• Data were analyzed using descriptive statistics to summarize findings.

Main Results:

• While 96% of providers knew sugammadex can affect oral contraceptive effectiveness, only 47% were aware of aprepitant's similar potential.
• Knowledge regarding the recommended duration for alternative contraception post-sugammadex (52%) and aprepitant (35%) exposure was limited.
• Despite recognizing the clinical relevance and need for shared decision-making (SDM), providers rarely discussed contraception with patients preoperatively, especially concerning aprepitant (73% rarely/never).

Conclusions:

• Significant knowledge gaps exist among anesthesia providers regarding perioperative drug interactions with hormonal contraceptives (HCs).
• Enhanced education and consistent preoperative counseling are essential to facilitate informed shared decision-making (SDM) regarding medication choices and alternative contraception.
• Addressing these gaps will improve patient care by ensuring informed consent and adherence to necessary contraceptive precautions.