Outcomes of intrauterine device insertion training for doctors working in primary care.

BACKGROUND

Intrauterine devices (IUDs) are underused in Australia despite being one of the most effective, reversible methods of contraception.

OBJECTIVE

The objective of this article is to report on the outcomes of a competency-based IUD training program by Family Planning NSW for general practitioners (GPs).

METHODS

Pre-training and post-training questionnaires were used for a 12-month cohort study of GPs who undertook IUD insertion training.

RESULTS

Twenty-two GPs (92%) completed the follow-up questionnaire; 19 participants reported attempting a total of 238 IUD insertions, 212 (89%) of which were successful. Few complications were reported. Most participants cited inadequate remuneration, time constraints and lack of appropriate patients as barriers to performing IUD insertion. Nearly all (96%) were confident with IUD insertion in multiparous women, but only 46% felt confident inserting in nulliparous women. There was evidence of a reduction in referrals to external IUD inserters following training.

DISCUSSION: Training enabled GPs to insert IUDs in their practices, but more than two-thirds (68%) fitted fewer than 12 devices during follow-up. A number of barriers to IUD insertion in general practice can be addressed to improve community access.