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  • Title: Family physicians' practices regarding Norplant.
    Author: Tafelski T, Taylor C.
    Journal: J Fam Pract; 1994 Nov; 39(5):452-6. PubMed ID: 7964543.
    Abstract:
    BACKGROUND: Norplant is a method of long-term contraception that was introduced in the United States in January 1991. This study was designed to explore the extent to which family physicians currently offer and insert Norplant. METHODS: A cross-sectional descriptive survey design was used to elicit information from a random sample of family physicians belonging to the Ohio Academy of Family Physicians. RESULTS: Of the 242 (69% response rate) physicians responding to the questionnaire, 130 (54%) were offering Norplant to their patients and 60 (25%) were inserting the devices themselves. Physicians offering Norplant were more likely to be women, younger, board certified, and currently practicing obstetrics. The most common reasons cited by the 112 (46%) physicians who did not offer Norplant were concerns about side effects, lack of familiarity with the procedure, expense, and personal or religious reasons. Overall, 88% of physicians who offered Norplant to their patients were satisfied with the product's performance. CONCLUSIONS: Over one half of the physician participants were offering Norplant as a contraceptive option for their patients. Physicians who offered the system were satisfied with its performance, and many expressed the belief that this form of contraception might be particularly well suited to certain patient groups. In 1993, 242 family practice physicians belonging to the Ohio Academy of Family Physicians completed a questionnaire aimed to examine the extent to which family practice physicians currently offer and insert the contraceptive implant system, Norplant. 130 family practice physicians (54%) offered Norplant to their clients. 60 (25%) actually inserted the implants. Physicians who offered Norplant were more likely than those who did not offer it to be younger (38.8 vs. 47.8 years; p 0.0001), to be in practice for a shorter period of time (9.2 vs. 18 years; p 0.0001), to be female (32% vs. 15%; p 0.003), and to be board certified (96% vs. 83%; p 0.003). They were also more likely to have more than 30% of their practice consist of premenopausal women (36% vs. 20%; p 0.01), to offer obstetric care to patients (26% vs. 3%; p 0.0001), and to perform at least two procedures other than Norplant insertion (46% vs. 26%; p 0.003). The training approaches of the 60 physicians inserting Norplant themselves included training course or workshop (35%), self-taught (32%), taught by another family physician (20%), and trained by an obstetrician-gynecologist (15%). The leading reasons for not offering Norplant among the 112 physicians (46%) who did not offer Norplant were side effects (19%), unfamiliarity with Norplant (16%), personal or religious reasons (14%), too expensive for patients (13%), and not appropriate for patients (13%). 88% of the physicians offering Norplant were satisfied with its performance. 95% of those who inserted Norplant themselves were satisfied. Overall, the most common patient groups identified that would most benefit from Norplant included youth with compliance problems, women not wanting children within 5 years, older women unsure about sterilization, and unreliable pill takers, and women who cannot use estrogens. These findings suggest that family physicians can insert Norplant and thus broaden the scope of their services.
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