Increasing the availability of long-acting reversible contraception and medical abortion in primary care: the Australian Contraception and Abortion Primary Care Practitioner Support Network (AusCAPPS) cohort study protocol

Abstract

IntroductionAlthough primary care practitioners are the main providers of long-acting reversible contraception (LARC) and early medical abortion (EMA) in Australia, few provide these services. A professional community of practice (CoP) has the potential to improve LARC and EMA provision through evidence-based guidance, expert support and peer-to-peer engagement.The primary objective is to establish, implement and evaluate an innovative, multidisciplinary online CoP (AusCAPPS Network) to increase LARC and EMA services in Australian primary care. Secondary objectives are to (1) increase the number of general practitioners (GPs) and pharmacists certified to provide or dispense EMA, respectively, (2) increase LARC and EMA prescription rates and, (3) improve primary care practitioners’ knowledge, attitudes and provision of LARC and EMA.Methods and analysisA stakeholder knowledge exchange workshop (KEW) will be conducted to inform the AusCAPPS Network design. Once live, we aim to reach 3000 GPs, practice nurses and community pharmacists members. Changes in the number of GPs and pharmacists certified to provide or dispense EMA, respectively, and changes in the number of LARCs and EMAs prescribed will be gleaned through health service data. Changes in the knowledge attitudes and practices will be gleaned through an online survey with 500 individuals from each professional group at baseline and 12 months after members have joined AusCAPPs; and experiences of the AusCAPPS Network will be evaluated using interviews with the project team plus a convenience sample of 20 intervention participants from each professional group. The project is underpinned by the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, and a realist framework will inform analysis.Ethics and disseminationEthical approval was received from the Monash University Human Research Ethics Committee (No. 28002). Dissemination will occur through KEWs, presentations, publications and domestic and international networks.Trial registration numberACTRN12622000655741.

Changes in the numbers of hospital‐based abortions and outpatient early medical abortions in Victoria, 2012–22: a retrospective cohort study

“…The decline in the proportion of surgical abortions and the rise in that of medical abortions is a pattern consistent with pre‐pandemic findings for Australia 17 and other high income countries with liberal abortion laws 18 . Our findings suggest that local efforts to move early abortion care from hospitals to primary care by increasing the numbers of mifepristone–misoprostol prescribers and dispensers 12,19‐22 helped safeguard abortion access in Victoria during the COVID‐19 pandemic, when demands on hospitals were unusually high. Access to abortion in other Australian states during the pandemic should also be investigated.…”

Expanding community pharmacists’ scope of practice in relation to contraceptive counselling and referral: a protocol for a pragmatic, stepped-wedge, cluster randomised trial (ALLIANCE)

“…The detailing is modelled on the National Prescribing Service (NPS) approach and was codesigned with consumers, pharmacists and other key stakeholders during a stakeholder workshop in June 2022 44. It will introduce the intervention and involve sharing resources, identifying referral pathways and enrolling pharmacists in the AusCAPPS online community of practice (COP) 45…”

“…AusCAPPS is an online COP supporting primary care practitioners (GPs, practice nurses and community pharmacists) to deliver contraception and MA services 45. It offers an accessible web-based portal to support practitioners, who may feel isolated in dealing with clinical problems, to create networks and implement new approaches to care 45. COPs have successfully been used in Australia to improve evidence-based care, and in Canada to support contraception and abortion care 49 50.…”

“… 44 It will introduce the intervention and involve sharing resources, identifying referral pathways and enrolling pharmacists in the AusCAPPS online community of practice (COP). 45 …”

Reimagining medical abortion in Australia: what do we need to do to meet women's needs and ensure ongoing access?

“…Communities of practice can be a valuable resource for practitioners in the community, providing peer support, resources and information on best practice. Examples of communities of practice include the Australian Contraception and Abortion Primary Care Practitioner Support Network (AusCAPPS) initiative in Australia — a multidisciplinary online community supporting primary care providers to deliver contraception and abortion care 11 . By incorporating these workforce capacity building approaches into professional education at all levels, we will ensure that Australia is well equipped to provide high quality abortion care throughout the country in the future.…”