Hub for abortion and LARC services set to launch

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GPs are at the centre of a major new hub aimed at increasing medical abortion and long-acting reversible contraceptive availability which is set to launch later this year

GPs are at the centre of a major new hub aimed at increasing medical abortion and long-acting reversible contraceptive (LARC) availability, set to launch later this year.

The “community of practice” is designed to be a one-stop-shop where GPs can find resources, ask experts questions and develop networks with other primary care workers both locally and nationally.

This mammoth undertaking, which is being run through the Centre of Research Excellence in Sexual and Reproductive Health for Women in Primary Care (SPHERE), will also train and equip pharmacists and nurses to ensure that medications and devices can actually be delivered, especially in regional areas.

“The delivery of these kinds of services often needs a team approach and we need to not only support practices but also, in the case of medical abortion, support pharmacists to increase access of these service to women,” the centre’s director, Professor Danielle Mazza, who is head of the Department of General Practice at Monash University, said.

The RACGP is one of more than a dozen partner organisations, which include the federal government, RANZCOG, Family Planning organisations, Jean Hailes, Marie Stopes, the Pharmaceutical Society of Australia, nurses associations and the drug manufacturer Bayer.

Dr Lara Roeske, spokesperson for the RACGP, said the college was thrilled to support the AusCAPPS (The Australian Contraception and Abortion Primary Care Practitioner Support) network.

“It will increase the accessibility of services for Australian women and therefore reduce unplanned pregnancies and improve health outcomes,” she said.

Australia has one of the highest rates of unplanned pregnancies and abortion in the western world.

One in three Australian women will experience an unintended pregnancy in their lifetime, and US research indicates that half of unplanned pregnancies occur while a woman is using contraception.

In Australia, women were overwhelmingly prescribed less efficacious types of contraception, Dr Roeske said.

“We have […] an urgent need to improve and update contraceptive services, and particularly access to long acting reversible contraception”, she said.

So far the uptake of medical abortion and LARCs have been minimal in primary care.

“In December 2017, there were only about 703 GP certified prescribers of medical abortion out of an estimated, at that time, 34,000 practicing GPs,” Dr Roeske said, adding it was unclear how many were actively providing the service now.

This was partly because some GPs felt medical termination was out of scope, and those that did deliver the service might feel stigmatised and isolated, she said.

To combat this, the AusCAPPS Network will provide peer support, referral pathways, supervision and mentorship.

The network is designed as a centralised repository that directs practitioners to the most up-to-date, best practice information, as well as a social platform for moderated sharing of tips and models of best practice.

The network was modelled on a “very successful” program run in Canada, Professor Mazza said.

Dr Roeske and Professor Mazza were optimistic that the participation of the Department of Health and other stakeholders would help remove regulatory barriers to medical abortion, as they saw in the Canadian program.

GPs are encouraged to register their interest on the SPHERE website so that they can be notified when the project launches in August. The community of practice is set to be made live by 2021.

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