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Barriers to the prescription of LARCs in general practice in New Zealand-a qualitative research study.

AIM
New Zealand has a high rate of unplanned pregnancy but a low rate of uptake of long-acting reversible contraception (LARCs), the most effective forms of contraception. This study aims to determine some of the barriers faced by general practitioners in New Zealand who wish to offer LARCs to their patients.


METHODS
General practitioners (n=17) were interviewed for this qualitative research study. The interviewees were asked about their experiences prescribing LARCs for their patients, any barriers they had experienced and how they felt any barriers described could best be overcome. Recorded interviews were examined using an inductive process of thematic analysis to generate codes to categorise the key patterns emerging from the data, in accordance with Braun and Clarke's six-phase framework.


RESULTS
There were three main themes identified as barriers to the provision of LARCs in general practice in New Zealand: a lack of funding for contraception provision in primary care, resulting in a high cost for LARC insertion for patients; poor access to procedural training; and the current Special Authority criteria for the LNG-IUS (Mirena©) IUS, which restricts its availability as a contraceptive option.


CONCLUSIONS
In order to increase the uptake of LARCs in New Zealand, robust primary care training and funding for contraception will be required. In addition, unrestricted funding for the LNG-IUS (Mirena) would increase the choice of effective LARCs available for all women.