Documentation of contraceptive counseling in female veterans of reproductive age

Abstract

Abstract Purpose To assess the rate at which contraceptive counseling is provided to women of childbearing age prescribed teratogenic medications at Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC). Women of childbearing age comprise a large demographic of women veterans and may require contraceptive counseling in the event a potentially teratogenic medication is prescribed. According to multiple studies, overall documentation of contraceptive counseling occurs in approximately half of this population or less. The rate of documented contraceptive counseling at MEDVAMC is unknown. Methods A retrospective chart review of electronic health records was conducted from January 2017 to August 2018. Patients included were female veterans between 18 and 45 years of age who made 2 or more visits to MEDVAMC prior to filling a prescription for a HMG-CoA reductase inhibitor (statin), angiotensin-converting enzyme inhibitor, or angiotensin II receptor blocker. Charts were screened for documentation of contraceptive counseling (including family planning counseling), prescribed contraception, and pregnancy testing prior to dispensing of a potentially teratogenic prescription. Results There were 172 female veterans included in this project. Documentation of contraceptive counseling occurred in 63% (n = 108) of patients; in total, 42% (n = 73) of patients were on some form of contraception, with the most common being oral contraceptive pill (used by 30% of women). Conclusion The rate of documentation of contraceptive counseling at MEDVAMC was found to be higher than rates reported in national studies. As we continue to strive to provide exceptional care for our women veterans, we would like to continue to increase the education and awareness on this matter.