P140 Missed opportunities for ensuring adequate contraception: lessons from a rural sexual health service. (18th May 2015)

• Record Type: Journal Article
• Authors: Budd, Lena; Pearce, Amy; Keane, Frances; Morris, George
• Is Part Of: Sexually transmitted infections. Volume 91(2015)Supplement 1
• Page Start: A62
• Page End: A62
• Publication Date: 2015-05-18
• Subjects: Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2015-052126.183
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Background/introduction: Our county-wide service is undergoing increasing integration which makes public health sense. Ideally, risk of both sexually transmitted infections and pregnancy should be addressed with patients. Aim(s)/objectives: We looked at missed opportunities for ensuring adequate contraception during routine GU appointments. Methods: A retrospective notes review of 50 consecutive new female attendances over 2/12 was conducted, with a follow up at 4/12 to check contraception initiation or pregnancy. Results: Consultations were conducted by 16 different staff, 44%(7) of whom are trained to initiate oral contraceptive pills (OCPs), 4 fit implants and 2 fit IUCD/IUS. 23 and 27 patients were seen by nurses and doctors respectively. Contraception methods, including none, were universally documented. 22(44%) patients were using long acting reversible methods of contraception (LARC) and 28%(14) an OCP. Pill compliance was documented in 5(36%) and advice given in 1 case. Only 4(14%) of the 28 non –LARC patients had LARC discussion. 7 patients used condoms and 7 no contraception. 5(36%) of these were advised to book a contraception clinic (CC)/GP appointment for contraception, 2 of whom failed to attend a subsequent CC. 1 patient was quick- started on an OCP. 2 patients were known to have conceived during the subsequent 4/12; 1 had LARC and 1 OCP at initial visit. 6(12%) and 1 patient/s were deemed at risk of pregnancy and appropriately provided with emergency contraception respectively. Discussion/conclusion: There were missed opportunities to maximise contraception efficacy. Time restrictions and lack of staff training pose barriers which we need to address.