Primary care physician familiarity with U.S. medical eligibility for contraceptive use

Abstract

Background: In May 2010, the Centers for Disease Control and Prevention (CDC) released the US Medical Eligibility Criteria for Contraceptive Use (MEC) to provide evidence-based guidance on contraceptive safety in US women with medical conditions. The CDC MEC was adapted from similar World Health Organization (WHO) guidelines.

Methods: A total of 754 US obstetrician-gynecologists, family physicians, and internists were surveyed at national conferences specific to each specialty between April and September 2011. The survey assessed prior use of the WHO and CDC MEC and provided case questions to answer using the CDC MEC guidelines.

Results: The respondents included 190 (25%) obstetrician-gynecologists, 326 (43%) family physicians, and 239 (32%) internists. Only 39% of respondents had heard of either MEC, and only 23% had previously used one or both MECs. Among the 120 (16%) respondents who had previously used the CDC MEC, utilization rates differed significantly by specialty (27%, 12%, and 13%, respectively) but not by gender. When the CDC MEC was provided for participants to use for two case questions, only 39% and 80% of participants gave correct answers.

Conclusions: Although the CDC MEC is designed to be used regularly by primary care and specialty physicians, relatively few used it in the first year after its release. Even when the CDC MEC is provided to assist in answering case questions, physicians appear to have difficulty answering correctly. More work is needed to disseminate and clarify the CDC MEC.