Addressing Contraceptive Counseling and LARC Prescription amid Mental Illness with Primary Providers

Purpose: The purpose of this quality improvement project was to evaluate provider knowledge regarding contraceptive counseling and LARCs in women affected by mental illness.Background: In Arizona, 51% of 61,000 pregnancies were unintended in women aged 15-44 in 2010. Potential barriers of healthcare providers working with this population to obviate risky behavior is misinformation, lack of knowledge, and lack of comfort with these patients. Long-acting reversible contraceptives (LARCs), such as arm implants and intrauterine devices (IUDs), are highly effective and eliminate the inconsistency and misuse of their short-acting counterparts. Methods: The subjects were primary care providers at a local community health center. The project utilized a one-group pretest/post-test design with an evidence-based education intervention on the topic of contraceptive counseling and LARC prescription in women affected by mental illness. The design is descriptive and utilizes a pre- and post-assessment process offered before and after a targeted education session for providers on contraceptive counseling and LARC prescription for women of childbearing age affected with mental illness. Results: For this specific site, an educational intervention did show an increase in provider knowledge regarding contraceptive counseling and LARC prescription in women affected by mental illness. Intent to change practice was also indicated after the educational intervention as well. 22.2% of the providers reported their practice will be significantly changed (n=5), 44.4% reported more change (n=4), 22.2% reported some change (n=3), 11.1% reported little change (n=2), and 0% reported no change (n=1). 55.6% reported they would consult more with psychiatric colleagues surrounding the need for contraception, compared to the 44.4% who would make no changes to their current practice, and 0% would consult less. Implication: Contraceptive counseling and LARC prescription is needed in a primary care provide