Opportunities missed: improving the rate of contraceptive counseling or provision when prescribing reproductive-aged women potentially teratogenic medications in a family medicine resident clinic

BackgroundStudies show poor documentation of contraceptive counseling when prescribing women teratogenic medications, suggesting a missed opportunity for contraceptive education.Study DesignA retrospective chart review of selected Food and Drug Administration class D and X medications evaluated the office visit initiating this medication for documentation of either contraceptive counseling or provision. Following an educational intervention, another retrospective review was conducted to determine if the rate of counseling improved.ResultsThe initial rate of documented counseling was 46% and improved to 80% following the educational intervention (p=.0002), an improvement in both overall rate and that seen in the previous year.ConclusionsThis study is the first to document contraceptive counseling rates when providing teratogenic medications in a training setting. It illustrates a need for increased attentiveness in primary care training practices to the risks of teratogenic medications and the need for comprehensive contraceptive counseling. Simple interventions may improve this rate and decrease missed opportunities.