A nurse-led model of care to improve access to contraception and abortion in rural general practice: Co-design with consumers and providers.
Jessica E Moulton, Noushin Arefadib, Jessica R Botfield and 6 others
PMID 38953531WHAT IT FOUND
Rural consumers and clinicians prioritised stigma reduction, sensitive booking, privacy, nurse-led assessment and follow-up, and clear GP backup in a draft nurse-led model for medication abortion and implant contraception.
The model was not tested.
Key findings
01Participants said stigma and structural barriers could delay time-sensitive care; they suggested normalising services, flexible booking, reserved appointments, reception training, local relationships and in-clinic stock.
02The proposed pathway assigned nurses to assessment and implant insertion, and GPs to consent and prescribing.
03Telehealth and home low-sensitivity pregnancy tests were proposed to make follow-up more accessible for rural and remote consumers.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It reports stakeholder views and a draft model, not patient outcomes. It cannot show the model works, is safe or improves access. The workshop had 52 participants and limited representation from Aboriginal Community Controlled Health Services. Applicability for First Nations people is uncertain. The authors could not be certain about applicability to migrant and refugee groups and the LGBTQIA+ community. Participant gender, ethnicity and years of professional experience were not collected. This limits generalisability. The model still needs separate assessment of feasibility and acceptability before the ORIENT trial.
Declared interests
Some authors declared relationships with Bayer, Organon and MSD, including research and conference funding, speaker fees, education for doctors and advisory board roles. One author stated no personal remuneration for these services. Another author was a member of the Board of Directors of the Society of Family Planning and received family planning research grants from Canadian and UK governments and not-for-profit associations unrelated to the study.
The easy way to misread this
Do not read this as evidence that nurse-led contraception or abortion care works or is safe. It is a co-design workshop that produced a draft model for later testing.