Several areas exist in contraception practice where evidence for practice is deficient, yet clinical decisions need to be made.

The study aimed to find the practice habits of lead practitioners in contraception in specific clinical scenarios where the published evidence is inadequate to provide clear guidance to clinicians. Results can provide ‘Level V’ evidence for practice for the ‘nonexpert’ practitioner.

The study was conducted as a postal questionnaire mailed to the 205 lead practitioners. Their contact details were known through the Society of Consultants in Reproductive Health working in reproductive health in the National Health Service.

A total of 138 consultants returned completed questionnaires. Significant results included 100% of respondents being prepared to prescribe progestogen-only emergency contraception more than once in a cycle and 71% recommending two tablets daily of the progestogen-only pill for high body mass women.

Some questions had responses that showed clear majorities, providing a clear guide to practice, while other areas remain doubtful. Comments from respondents indicated significant interest in all areas covered and a desire for consensus on many issues. Indeed, the licensing and the advice from pharmaceutical companies are conservative. 

Reference: https://srh.bmj.com/content/30/4/229

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