Contraception Objectives and References

Objectives:

By the end of Family Medicine Clerkship, students will be able to:

1. Obtain an appropriate medical and sexual history (e.g. migraines, unprotected intercourse, smoking, depression, contraindications for common contraceptive methodologies)
2. Be able to list and explain the absolute contraindications for hormonal contraception.
3. Counsel patients on contraceptive options including:
a) patient preferences and values
b) risks and side effects
c) contraceptive methods and devices, both permanent and non-permanent
d) benefits & relative efficacy
e) barriers to access (e.g. cost)
f) proper use including initiation
g) potential drug interactions
h) emergency contraception
i) counsel patients on STI prevention and screen when appropriate
j) describe the role of family physicians in caring for patients with unintended pregnancy [this sub-objective overlaps with pregnancy care]

References:

Recommended Resources Addressing the Objectives
Contraception in Canada - a review (methods, characteristics, adherence, approaches to counselling) - 8 pages
Objectives covered: Fully: 1,3abdfghi Partially: 2,3ce
Fisher WA, Black A. Contraception in Canada: a review of method choices, characteristics, adherence and approaches to counselling. 
        CMAJ 2007 Mar 27;176(7):953-961.
PMID:17389445
Helping women choose appropriate hormonal contraception - 8 pages
More "real-life" guide to hormonal contraceptives; with more explanation for contraindications of hormonal contraception & more emphasis on cost
Objectives covered: 2, 3abde
Spencer AL, Bonnema R, McNamara MC. Helping women choose appropriate hormonal contraception: update on risks, benefits, and indications. 
        Am J Med 2009 Jun;122(6):497-506.
PMID:19486709
Contraception for adolescents (1 page - pg 386; read the rest for interest)
Includes handy comparison chart, listing contraceptive methods from most to least effective
Objectives covered: Fully: 3abcdfghi. Partially: 1,2,3e
Upadhya KK. Contraception for adolescents. Pediatr Rev 2013 Sep;34(9):384-394.
PMID:24000342

Careful counsel: Management of unintended pregnancy
Objectives covered: 3j
O'Reilly M. Careful counsel: Management of unintended pregnancy. J Am Acad Nurse Pract 2009 Nov;21(11):596-602.
PMID:19900221
Patient Information
FAQs on emergency contraception:


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