Knowledge, attitudes and practices of East Flemish general practitioners towards subscribing LARCs for adolescents

OBJECTIVE: While long acting reversible contraceptives (LARCs) offer a more reliable protection against unintended pregnancies than short acting reversible methods (SARCs), their uptake among adolescents in Flanders (Belgium) is low. This study assesses to what degree general practitioners constitute a barrier for the uptake of LARCs by adolescents. METHODS: We did an online survey among 79 general practitioners in East Flanders to assess their knowledge, attitudes and behaviours related to advising and prescribing LARCs to adolescents. RESULTS: Almost one third (31,6%) of respondents does not discuss LARCs with adolescents and a vast majority (87.3%) indicates to only recommend SARCs. Uncertainty of their own technical skills is among the main barriers, next to the perceived need to transfer the patient to a gynaecologist. Half of the respondents indicate that their practice is equipped to place implants and hormonal IUDs, one in four to place copper IUDs. Furthermore, responses indicate that prejudices and traditions play a role in the reluctance of general practitioners to recommend LARCs to adolescents. DISCUSSION: These results indicate that adolescents are not always offered the necessary information to make an informed choice between a full range of modern contraceptives. Another worrying finding is that most of the main reasons for hesitating to recommend LARCs to adolescents are provider-related barriers rather than reasons related to the well-being of the patients. CONCLUSION: Based on the data, we can say that (lack of) knowledge, skills and equipment of general practitioners constitute a barrier to uptake of LARCs by adolescents.