Women living in rural areas are more likely to experience an unintended pregnancy than those in metropolitan areas. They have less access to contraception and abortion care, due in part to geographical isolation, high costs and limited providers. While provision of long-acting reversible contraception (LARC) and early medical abortions (EMA) in primary care is acceptable to patients and can be safely provided in these settings, relatively few general practitioners (GPs) have undertaken the necessary training and even less in rural areas.
‘The limited number of health practitioners able to provide LARC and EMA is a huge barrier to women accessing timely and safe contraception and abortion care in Australia,’ says Professor Danielle Mazza, head of the Department of General Practice at Monash University.
The World Health Organization recommends enabling additional cadres of health practitioners, including nurses, to deliver contraception and abortion services. Nurses are supportive of initiatives that enable them to work to their full scope of practice to deliver reproductive health care. Nurse-led models of contraception and abortion care have been successfully implemented in rural community health centres and family planning clinics in Australia, however these are yet to be trialled or evaluated in the general practice setting.
The ORIENT study has been developed in response to this. The ORIENT study will implement and evaluate the effectiveness of a collaborative nurse-led model of care in general practice, that aims to increase access to LARC and EMA for women living in regional and rural Australia.
The ORIENT team has worked closely with consumers, primary care practitioners and partner organisations to co-design the nurse-led model of care. Implementation of the model of care will be supported by capacity-building activities for participating GPs and practice nurses, including:
- free, accredited online training on implant insertion and removal
- online education on delivery of LARC and EMA services
- one 60-minute online educational outreach session with clinical opinion leaders to support practices in preparing for implementation of the nurse-led model
- enrolment into the AusCAPPS Network, the Australian virtual community of practice for GPs, practice nurses and pharmacists to gain access to professional peer support, expertise and resources to support LARC and EMA service delivery.
In addition to expanding access to reproductive health care, participating practices and practitioners will also receive benefits in the form of financial reimbursement and CPD points.
We are currently recruiting regional and rural general practices across Australia to join the ORIENT study. To be eligible, practices must be located in MM 2-7 areas and have at least two GPs and one practice nurse willing to enrol in the study, with a practice manager acting as the study liaison.
Express interest via this form: https://redcap.link/jdcgo0n4
Read more about the ORIENT study here: www.spherecre.org/the-orient-study
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