A scheme that rewarded GPs for promoting long-acting reversible contraception may have helped reduce abortion rates, according to a new study.
Over a ten year period the scheme was associated with increased rates of LARC, reduced rates of other contraceptive prescriptions and reduced abortion rates, according to the study at Imperial College, London.
Researchers analysed GP records in England, Wales and Scotland over a decade, ending in 2014, to assess the impact of the Quality Outcomes Framework scheme.
Practices could earn about £6,000 a year for reaching a target for giving women information about LARCS after the scheme was introduced in 2009.
Researchers studied the records of 17 million patients in more than 600 practices.
They report a 38% greater reduction in abortions than was expected – equivalent to 5.3 per thousand women. LARC prescriptions increased by 13%, equivalent to 4.5 prescriptions per thousand women.
Researcher Dr Richard Ma, a GP, said: researcher on the study from Imperial’s School of Public Health said: “Our study suggests if women were better informed about more effective and reliable methods such as long-acting contraceptives, they might choose these over less reliable methods. This could reduce the number of unplanned and unwanted pregnancies.
“We expected this study would show the incentive had led to some change in behaviour – but we never expected it to reveal such a profound effect, especially for a simple intervention and a relatively modest incentive.”
Fellow researcher Professor Sonia Saxena said: “As women’s circumstances change, regular review of contraceptive needs from primary care professionals, such as their GP or practice nurse, may help women to make better decisions about contraceptive methods that are appropriate for their life stage.”
Impact of a pay-for-performance scheme for long-acting reversible contraceptive (LARC) advice on contraceptive uptake and abortion in British primary care: An interrupted time series study. PLoS Med 14 September 2020
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