Ms. Carolyne Burgess, MPH alumna, and Drs. Meredith Manze and Heidi Jones, professors at the CUNY Graduate School of Public Health and Health Policy published a systematic review of the impact of including reproductive intention screening in primary care on health outcomes. The work was published in Family Practice.
[Photos: (left to right) Ms. Carolyne Burgess, Dr. Meredith Manze, and Dr. Heidi Jones]
The systematic review included studies published in English between 2000 and 2017 and whose population was patients of reproductive age (15 to 49 years). The research team reviewed 24,780 articles.
Only nine published articles met the inclusion criteria: prospective studies (four randomized controlled trials and five observational studies) with comparison groups, from which modest improvements in knowledge and behaviors were seen. Two randomized controlled trials and one quasi-experimental cohort study showed a statistically significant increase in knowledge related to healthier pregnancy, such as the benefits of folic acid supplementation, and increased risk profiles for those with chronic conditions. Among studies measuring contraceptive use, only one cohort study showed any increase while the randomized controlled trial and retrospective cohort did not show a statistically significant effect. Neither of the two randomized controlled trials that assessed the provision of contraception by primary care providers for those not desiring pregnancy found increased access to contraception, although one found increased documentation of contraception in electronic medical records. Acceptability of reproductive intention screening was measured in seven studies, and participant satisfaction was high in all seven studies.
The research team determined that while including a question about pregnancy intentions in the primary care setting has the potential to improve patient outcomes, more high quality studies are needed to test its impact on health outcomes before making wide scale recommendations for its inclusion in the primary care encounter.