Improving access to effective contraception

Monash University

SPHERE welcomes the upcoming Pharmaceutical Benefits Scheme listing of Kyleena® (levonorgestrel-releasing intrauterine system), which was announced today by the Federal Government. Our research has shown that increasing GPs' and women's knowledge of long-acting reversible contraception (LARCs) and providing rapid referral clinics for LARC insertion can increase the uptake of this form of contraception among Australian women. LARCs (implants or intrauterine devices (IUDs) are the most effective way of preventing unintended pregnancies, but just 11 per cent of Australian women currently use them.

A recent study conducted by researchers at Monash University's SPHERE NHMRC Centre for Excellence in Women's Sexual and Reproductive Health in Primary Care found that when GPs were provided with training in effectiveness-based contraceptive counselling and a portal to directly book an insertion procedure in a LARC insertion clinic, there was a significant increase in LARC uptake. The randomised controlled trial involving 57 GPs and 740 women across Melbourne found that 46.6 percent of women attending those GPs who had received the training and access to rapid referral to the insertion clinics opted for LARCs, compared with 32.8 percent of women who received usual care. Lead researcher and Director of SPHERE, Professor Danielle Mazza, said many national and international bodies recommended the use of LARCs because they were the most effective form of contraception. She said empowering GPs with the tools to provide evidence based information about LARCs and timely access to LARC insertion was extremely important because women present to GPs for advice on contraception and they are a trusted source of information. "If GPs don't offer an implant or an IUD as an option, then women are unlikely to consider them," she said. Professor Mazza said that it was important for governments to improve access to LARCs to ensure women were able to better plan their pregnancies and achieve their reproductive goals. "This study is really important because it is the first to demonstrate that interventions delivered in the general practice setting can result in increased LARC uptake. This is especially important in Australia where GPs are the frontline contraceptive providers," she said. "These findings show that the government could increase LARC uptake in Australia by investing in contraceptive training for GPs so that they can support women in making an informed choice and establishing LARC insertion clinics so that women can get their LARC inserted easily and don't experience long delays."

The study results, conducted as part of the Australian Contraceptive Ch0ice pRoject - ACCORd, have been published in the American Journal of Obstetrics and Gynecology.

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