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Journal of General Internal Medicine

, Volume 25, Issue 4, pp 291–297 | Cite as

Providing Contraception for Women Taking Potentially Teratogenic Medications: A Survey of Internal Medicine Physicians’ Knowledge, Attitudes and Barriers

  • David L. EisenbergEmail author
  • Catherine Stika
  • Ami Desai
  • David Baker
  • Kathleen J. Yost
Original Article

ABSTRACT

BACKGROUND

The majority of women prescribed category D or X medications may not receive adequate contraceptive counseling or a reliable contraceptive method. Physicians who prescribe potentially teratogenic medications have a responsibility to provide women with contraceptive counseling, a method of highly-effective contraception, or both.

OBJECTIVE

Investigate the knowledge, beliefs and barriers of primary care physicians toward providing adequate contraception to women taking potential teratogens.

DESIGN & PARTICIPANTS

Self-administered confidential survey of primary care internal medicine physicians at an urban, academic medical center.

MEASUREMENTS

Knowledge of potential teratogenic medications and contraceptive failure rates was assessed. Participants’ beliefs about adequacy of their medical education, practice limitations and attitudes toward improving provision of contraception to women on potential teratogens were assessed.

RESULTS

One hundred and ten physicians responded (57.3%). Nearly two-thirds (62.3%) of participants had cared for reproductive aged women taking category D or X medications in the past year. The mean percent of correctly identified category D or X medications was 58.4% (SD 22.1%). The mean percent correct for knowledge of published contraceptive failure rates was 64.6% (SD 23.1%). Most respondents (87.6%) felt it is the responsibility of primary care physicians to provide contraception. Time constraints were reported to be somewhat or very limiting by 61.3% and over half felt medical school (63.2%) or residency (58.1%) inadequately prepared them to prescribe or counsel about contraceptives.

CONCLUSIONS

Primary care physicians commonly encounter reproductive age women taking category D or X medications, but may lack sufficient knowledge and time to counsel about potential teratogens and contraception to prevent fetal exposure to these drugs.

KEY WORDS

adult contraception counseling female humans physician practice patterns physician behavior pregnancy prescription drugs primary care survey teratogens women’s health 

Notes

Acknowledgements

Funded by a grant supplied by a generous anonymous donor. This research was presented at the Fellowship in Family Planning National Conference in Chicago, May, 2009. We would like to thank the faculty and staff of the Research and Education for Academic Achievement (REACH) Network and the Northwestern University Clinical and Translational Sciences Institute (NUCATS) for their support during this project (grant UL1RR025741).

This research could not have been completed without the assistance of Charlie Zei and Jason Thompson, research assistant and programmer, respectively.

Conflicts of Interest

David Eisenberg has received honoraria and consulting fees from Bayer Schering Pharma and Haymarket Media. Catherine Stika has received a grant from Boehringer Ingelheim and has a grant pending from Biosante Pharma.

Supplementary material

11606_2009_1215_MOESM1_ESM.pdf (164 kb)
ESM 1 Appendix: Written version of survey (PDF 164 kb)

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Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • David L. Eisenberg
    • 1
    Email author
  • Catherine Stika
    • 2
  • Ami Desai
    • 3
  • David Baker
    • 3
  • Kathleen J. Yost
    • 4
  1. 1.Department of Obstetrics & Gynecology, Division of Clinical ResearchWashington University in St. Louis School of MedicineSt. LouisUSA
  2. 2.Department of Obstetrics & GynecologyNorthwestern University Feinberg School of MedicineChicagoUSA
  3. 3.Department of Internal MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  4. 4.Department of Health Sciences ResearchMayo ClinicRochesterUSA

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