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Master Thesis

Contraception et risque vasculaire : évaluation des pratiques professionnelles concernant la prescription de la contraception orale en première intention

Abstract : Objective. Recently, there has been substantial media coverage against third-generation birth control pills. It recalled the augmentation of vascular risks due to their consumption. It led to the cutting back on their reimbursement by the government. Following this, numerous recommendations concerning birth control were updated and sent back to professionals of the health sector. The first aim of this work was to present the professional practices, regarding consultations for the prescription of first-line oral contraception. The second aim was to assess whether the professional's strategies for the prescription choices were consistent with the recommendations. Methods. This descriptive study was conducted from November 2013 to January 2014 using a questionnaire distributed to health professionals able to prescribe first-line oral contraception, ie general practitioner, obstetricians and midwives. It targeted professionals working in private, hospital, PMI, family planning and orthogenic center. The questionnaire consisted of three parts and the questions were based on the recommendations of the HAS 2013. The first part analyzed the profile of the participants, the second one studied the course of a consultation for first-line oral contraception, and the third part presented five clinical cases to analyze the contraceptive choice of professionals. Results and conclusion. The majority of the consultations were conducted in accordance with the recommendations of contraception. 94% prescribed first-line 2nd generation pill for a patient without any medical history and with a normal result at the clinical examination. Prescriptions are relatively homogeneous amongst all professionals, except with patient suffering from acne. In this case 24% of all professionals prescribe a 3rd generation pill. In this situation, the midwife would prescribe significantly (p = 0.00377) more 2nd generation pills than obstetricians. It appears that in case of a disease, 37% of the midwives don't prescribe any pill. This heterogeneity in the prescriptions is linked to the different places of practice between liberal midwives and employed midwives.
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https://dumas.ccsd.cnrs.fr/dumas-01002682
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Submitted on : Friday, June 6, 2014 - 3:39:50 PM
Last modification on : Friday, January 10, 2020 - 3:42:28 PM
Long-term archiving on: : Saturday, September 6, 2014 - 12:16:23 PM

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Kathleen Fourche. Contraception et risque vasculaire : évaluation des pratiques professionnelles concernant la prescription de la contraception orale en première intention. Gynécologie et obstétrique. 2014. ⟨dumas-01002682⟩

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