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. 2023 May 29:41:e2022060.
doi: 10.1590/1984-0462/2023/41/2022060. eCollection 2023.

Why are pediatricians uncomfortable with prescribing emergency contraception for adolescents?

Renata Vieira Amorim  1 , Marco Antônio Barbieri  2 , Camila Bôtto-Menezes  1   3 , Fábio Carmona  2 , Alexandre Archanjo Ferraro  4 , Heloisa Bettiol  2
Affiliations

Why are pediatricians uncomfortable with prescribing emergency contraception for adolescents?

Renata Vieira Amorim et al. Rev Paul Pediatr. .

Abstract
in English, Portuguese

Objective: Emergency contraception (EC) is an effective and safe method for preventing unplanned pregnancy after unprotected sexual intercourse among adolescents but is infrequently prescribed by pediatricians. Because of the scarcity of data on the discomfort with EC prescription among physicians in Brazil, this study aimed to identify associated factors with discomfort with EC prescription among pediatricians in the state of Amazonas.

Methods: A web-based, cross-sectional study including sociodemographic data, knowledge, attitudes, and discomfort with EC prescription was used. Multivariate logistic regression and artificial intelligence methods such as decision tree and random forest analysis were used to identify factors associated with discomfort with EC prescriptions.

Results: Among 151 physicians who responded to the survey, 53.0% were uncomfortable with prescribing EC, whereas only 33.1% had already prescribed it. Inexperience was significantly associated with discomfort with EC prescription (odds ratio 4.47, 95% confidence interval 1.71-11.66). Previous EC prescription was protective against discomfort with EC prescription in the three models.

Conclusions: EC is still infrequently prescribed by pediatricians because of inexperience and misconceptions. Training these professionals needs to be implemented as part of public health policies to reduce unplanned adolescent pregnancy.

Objetivo:: A contracepção de emergência (CE) é um método eficaz e seguro para prevenir gravidez não planejada após relação sexual desprotegida entre adolescentes, mas raramente prescrito por pediatras. Diante da escassez de dados sobre o desconforto com a prescrição de CE entre médicos no Brasil, o objetivo deste estudo foi identificar fatores associados a esse desconforto entre pediatras do estado do Amazonas.

Métodos:: Uma pesquisa do tipo e-survey coletou dados sociodemográficos, conhecimento, atitudes e desconforto com relação à prescrição de CE. Métodos de regressão logística multivariada e inteligência artificial, como árvore de decisão e random forest, foram usados para identificar fatores associados ao desconforto para a prescrição de CE.

Resultados:: Entre os 151 médicos que responderam à pesquisa, 53,0% sentiam-se desconfortáveis para prescrever CE e apenas 33,1% já a haviam prescrito. A inexperiência foi associada a esse desconforto (odds ratio — OR 4,47, intervalo de confiança — IC95% 1,71–11,66). A prescrição prévia de CE foi fator de proteção com relação ao desconforto nos três modelos.

Conclusões:: A CE ainda é pouco prescrita por pediatras. Apesar de sua segurança e eficácia, a inexperiência e conceitos equivocados foram associados ao desconforto para sua prescrição. Investigações sobre o assunto são importantes para subsidiar políticas públicas de saúde para a redução da gravidez não intencional na adolescência.

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Conflict of interest statement

Conflict of interests The authors declare there is no conflict of interests.

Figures

Figure 1.
Figure 1.. Study flowchart.
Figure 2.
Figure 2.. Decision tree for discomfort with emergency contraception prescription. Practical experience with previous emergency contraception prescription was the most relevant variable in the model. Among those without practical experience, factors associated with more discomfort with emergency contraception prescription were inexperience and working in public outpatient clinics. Among those with practical experience, the factors increasing discomfort with emergency contraception prescription were the belief that emergency contraception compromises adherence to other methods and stimulates risky sexual behavior and having graduated before 2001.
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References

    1. Upadhya KK, Committee on Adolescence Emergency contraception. Pediatrics. 2019;144:e20193149. doi: 10.1542/peds.2019-3149. - DOI - PubMed
    1. Hsiang D, Dunn S. Emergency contraception. CMAJ. 2016;188:E536. doi: 10.1503/cmaj.160720. - DOI - PMC - PubMed
    1. Cameron ST, Li H, Gemzell-Danielsson K. Current controversies with oral emergency contraception. BJOG. 2017;124:1948–56. doi: 10.1111/1471-0528.14773. - DOI - PubMed
    1. Leelakanok N, Methaneethorn J. A systematic review and meta-analysis of the adverse effects of levonorgestrel emergency oral contraceptive. Clin Drug Investig. 2020;40:395–420. doi: 10.1007/s40261-020-00901-x. - DOI - PubMed
    1. Shen J, Che Y, Showell E, Chen K, Cheng L. Interventions for emergency contraception. Cochrane Database Syst Rev. 2019;1:CD001324. doi: 10.1002/14651858.CD001324.pub6. - DOI - PMC - PubMed