Evidence map›Paper›PMID 23149528›Full record

Trial reportAnnals of family medicine

Promoting safe prescribing in primary care with a contraceptive vital sign: a cluster-randomized controlled trial.

Eleanor Bimla Schwarz, Sara M Parisi, Sanithia L Williams, Grant J Shevchik, Rachel Hess

Open access · diamondAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 3 pooled it
2.8field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Eleanor Bimla SchwarzDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA. schwarzeb@upmc.edu
Sara M Parisi
Sanithia L Williams
Grant J Shevchik
Rachel Hess
University of Pittsburgh · USUniversity of Pittsburgh Medical Center · US

Funding

Harnessing Health IT to Prevent Medication-Induced Birth DefectsR18HS017093 · AHRQ · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SCHWARZ, ELEANOR BIMLA · 2007 to 2009
$1.2M
Contraceptive Services/Primary Care to Prevent Birth DefectsK23HD051585 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SCHWARZ, ELEANOR BIMLA · 2006 to 2010
$631k
AHRQ HHS R18 HS017093AHRQ HHS R18HS017093NICHD NIH HHS K23 HD051585NICHD NIH HHS K23HD051585
6 · The paper itself

Abstract

purposeRoutine assessment of women's pregnancy intentions and contraceptive use-a so-called contraceptive vital sign-may help primary care physicians identify patients who need preconception or contraceptive counseling and be of particular benefit when teratogenic medications are prescribed.

methodsWe conducted a cluster-randomized controlled trial to evaluate the effect of a contraceptive vital sign on primary care documentation of contraceptive use and change in primary care physicians' provision of family planning services. Academic internists in the intervention group (n = 26) were provided with information on their female patients' pregnancy intentions and contraceptive use immediately before visits; internists in the control group (n = 27) received only standard intake information. Data were abstracted from the electronic health record for 5,371 visits by 2,304 women aged 18 to 50 years.

resultsDocumentation of contraception increased from baseline, from 23% to 57% in the intervention group, but remained 28% in the control group, a change of +77.4 (95% confidence interval [CI], 70.7 to 84.1) adjusted percentage points in the former vs +3.1 (95% CI, 1.2 to 5.0) in the latter (P <.001). For visits involving a teratogenic prescription, documentation increased from 14% to 48% in the intervention group and decreased from 29% to 26% in the control group, a change of +61.5 (95% CI, 35.8 to 87.1) adjusted percentage points in the former vs -0.3 (95% CI, -4.3 to 3.6) in the latter (P <.001). Provision of new family planning services increased only minimally with this intervention, however. When women with documented nonuse of contraception were prescribed potential teratogens, only 7% were provided family planning services.

conclusionsA contraceptive vital sign improves documentation of contraceptive use; however, ongoing efforts are needed to improve provision of preconception and contraceptive services.

Indexed as

AdolescentAdultContraception BehaviorDocumentationFamily Planning ServicesFeasibility StudiesFemaleHumansMiddle AgedPractice Patterns, Physicians'PregnancyPrescriptionsPrimary Health CareProgram EvaluationTeratogensYoung AdultTeratogens

Identifiers

PMID23149528
PMCPMC3495925
OpenAlexW2148442372

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.