Abstract
Background
Despite the medical evidence, few women of reproductive age in the United States use
intrauterine contraception (IUC) in comparison with women worldwide. To reduce cost
as a barrier, Kaiser Permanente removed the cost to the patient for IUC throughout
California in 2002. The goal of this study was to evaluate whether providing evidence-based
information about IUC would result in changes in the knowledge, attitudes and practice
patterns of clinicians and in greater IUC utilization as compared with removing cost
alone.
Study Design
A comprehensive education intervention was conducted in half of Kaiser Permanente
Northern California ob-gyn departments. To make comparisons between the intervention
and comparison sites, we surveyed clinicians in both groups before and after the intervention
about their IUC knowledge, attitudes as well as practice patterns and collected utilization
data for 27 months.
Results
Statistically significant changes in attitudes and practice patterns were reported
by the intervention group as compared with the usual care comparison group. By the
end of the study, change in IUC utilization was significantly greater in the intervention
group (utilization rate=9.57/1000) as compared with the comparison group (utilization
rate=7.35/1000) (p=.02).
Conclusion
A multifaceted approach to providing evidence-based clinician and patient education
resulted in statistically significant reported changes in attitudes and practice patterns
and in greater IUC utilization as compared with usual practice.
Keywords
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Article info
Publication history
Published online: January 17, 2007
Accepted:
October 24,
2006
Received in revised form:
October 23,
2006
Received:
July 28,
2006
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
