Is there a role for practice nurses in increasing the uptake of the contraceptive implant in primary care?: survey of general practitioners and practice nurses

Background: Uptake of long-acting reversible contraception (LARC) in Australia is low. With appropriate training, practice nurses (PNs) in general practice clinics could help increase LARC uptake. Methods: General practitioners (GPs) and PNs completed a postal survey to assess contraceptive implant knowledge and attitudes towards PNs providing contraception counselling and inserting the contraceptive implant. chi(2) tests were used to detect differences between GPs and PNs. Unadjusted odds ratios (OR) for the association between demographic characteristics and knowledge and attitudes towards the contraceptive implant were calculated for GPs and PNs separately. Results: Four hundred and sixty-eight GPs and 1142 PNs participated. GPs had greater knowledge about LARC than PNs (59% vs 33%; P < 0.01). A similar proportion of GPs and PNs (70%) agreed that PNs could become involved in contraceptive counselling. Among GPs, urban-based GPs were less likely to agree that their clinic would be supportive of the PN inserting the implant (OR = 0.6; 95% CI: 0.4-0.9). Among PNs, older PNs (OR = 0.5; 95% CI: 0.4-0.7) were less likely to agree that the clinic would support PNs inserting the contraceptive implant, but those with Pap test training were more likely to agree (OR = 2.1; 95% CI: 1.5-3.0). Conclusions: This study found high levels of acceptability for PNs to provide contraceptive counselling and insertion of the contraceptive implant. Further research is needed to evaluate the impact of potential interventions that equip PNs with the skills to consult women about contraception and insert the contraceptive implant on LARC uptake.