Increasing the uptake of long-acting reversible contraception in general practice: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial protocol
Introduction The increased use of long-acting reversible contraceptives (LARCs), such as intrauterine devices and hormonal implants, has the potential to reduce unintended pregnancy and abortion rates. However, use of LARCs in Australia is very low, despite clinical practice guidance and statements...
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| Format: | Article |
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BMJ Publishing Group
2016-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/6/10/e012491.full |
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| author | Danielle Mazza Angela Taft Kevin McGeechan Kirsten Black Heather McKay Marion Haas Jayne Lucke Jeffery F Peipert |
| author_facet | Danielle Mazza Angela Taft Kevin McGeechan Kirsten Black Heather McKay Marion Haas Jayne Lucke Jeffery F Peipert |
| author_sort | Danielle Mazza |
| collection | DOAJ |
| description | Introduction The increased use of long-acting reversible contraceptives (LARCs), such as intrauterine devices and hormonal implants, has the potential to reduce unintended pregnancy and abortion rates. However, use of LARCs in Australia is very low, despite clinical practice guidance and statements by national and international peak bodies advocating their increased use. This protocol paper describes the Australian Contraceptive ChOice pRojet (ACCORd), a cluster randomised control trial that aims to test whether an educational intervention targeting general practitioners (GPs) and establishing a rapid referral service are a cost-effective means of increasing LARC uptake.Methods and analysis The ACCORd intervention is adapted from the successful US Contraceptive CHOICE study and involves training GPs to provide ‘LARC First’ structured contraceptive counselling to women seeking contraception, and implementing rapid referral pathways for LARC insertion. Letters of invitation will be sent to 600 GPs in South-Eastern Melbourne. Using randomisation stratified by whether the GP inserts LARCs or not, a total of 54 groups will be allocated to the intervention (online ‘LARC First’ training and rapid referral pathways) or control arm (usual care). We aim to recruit 729 women from each arm. The primary outcome will be the number of LARCs inserted; secondary outcomes include the women's choice of contraceptive method and quality of life (Short Form Health Survey, SF-36). The costs and outcomes of the intervention and control will be compared in a cost-effectiveness analysis.Ethics and dissemination The ACCORd study has been approved by the Monash University Human Research Ethics Committee: CF14/3990-2014002066 and CF16/188-2016000080. Any protocol modifications will be communicated to Ethics Committee and Trial Registration registry. The authors plan to disseminate trial outcomes through formal academic pathways comprising journal articles, nation and international conferences and reports, as well as using more ‘popular’ strategies including seminars, workshops and media engagements.Trial registration number ACTRN12615001346561. |
| format | Article |
| id | doaj-art-2209136b774b4de1be5aeb1a48d8a6dc |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2016-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2209136b774b4de1be5aeb1a48d8a6dc2025-02-12T01:25:10ZengBMJ Publishing GroupBMJ Open2044-60552016-10-0161010.1136/bmjopen-2016-012491Increasing the uptake of long-acting reversible contraception in general practice: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial protocolDanielle Mazza0Angela Taft1Kevin McGeechan2Kirsten Black3Heather McKay4Marion Haas5Jayne Lucke6Jeffery F Peipert7SPHERE NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Clayton, Victoria, AustraliaJudith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia5School of Public Health, University of Sydney, Sydney, New South Wales, AustraliaObstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, AustraliaDepartment of Family Practice, University of British Columbia, Vancouver, British Columbia, CanadaCentre for Health Economics Research & Evaluation, University of Technology Sydney, Sydney, New South Wales, AustraliaSchool of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia8Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, Indiana, USAIntroduction The increased use of long-acting reversible contraceptives (LARCs), such as intrauterine devices and hormonal implants, has the potential to reduce unintended pregnancy and abortion rates. However, use of LARCs in Australia is very low, despite clinical practice guidance and statements by national and international peak bodies advocating their increased use. This protocol paper describes the Australian Contraceptive ChOice pRojet (ACCORd), a cluster randomised control trial that aims to test whether an educational intervention targeting general practitioners (GPs) and establishing a rapid referral service are a cost-effective means of increasing LARC uptake.Methods and analysis The ACCORd intervention is adapted from the successful US Contraceptive CHOICE study and involves training GPs to provide ‘LARC First’ structured contraceptive counselling to women seeking contraception, and implementing rapid referral pathways for LARC insertion. Letters of invitation will be sent to 600 GPs in South-Eastern Melbourne. Using randomisation stratified by whether the GP inserts LARCs or not, a total of 54 groups will be allocated to the intervention (online ‘LARC First’ training and rapid referral pathways) or control arm (usual care). We aim to recruit 729 women from each arm. The primary outcome will be the number of LARCs inserted; secondary outcomes include the women's choice of contraceptive method and quality of life (Short Form Health Survey, SF-36). The costs and outcomes of the intervention and control will be compared in a cost-effectiveness analysis.Ethics and dissemination The ACCORd study has been approved by the Monash University Human Research Ethics Committee: CF14/3990-2014002066 and CF16/188-2016000080. Any protocol modifications will be communicated to Ethics Committee and Trial Registration registry. The authors plan to disseminate trial outcomes through formal academic pathways comprising journal articles, nation and international conferences and reports, as well as using more ‘popular’ strategies including seminars, workshops and media engagements.Trial registration number ACTRN12615001346561.https://bmjopen.bmj.com/content/6/10/e012491.full |
| spellingShingle | Danielle Mazza Angela Taft Kevin McGeechan Kirsten Black Heather McKay Marion Haas Jayne Lucke Jeffery F Peipert Increasing the uptake of long-acting reversible contraception in general practice: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial protocol BMJ Open |
| title | Increasing the uptake of long-acting reversible contraception in general practice: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial protocol |
| title_full | Increasing the uptake of long-acting reversible contraception in general practice: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial protocol |
| title_fullStr | Increasing the uptake of long-acting reversible contraception in general practice: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial protocol |
| title_full_unstemmed | Increasing the uptake of long-acting reversible contraception in general practice: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial protocol |
| title_short | Increasing the uptake of long-acting reversible contraception in general practice: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial protocol |
| title_sort | increasing the uptake of long acting reversible contraception in general practice the australian contraceptive choice project accord cluster randomised controlled trial protocol |
| url | https://bmjopen.bmj.com/content/6/10/e012491.full |
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