Extended-use oral contraceptives and medically induced amenorrhea: Attitudes, knowledge and prescribing habits of physicians

Background: The study was conducted to determine whether geographic location, primary specialty, attitudes and knowledge influence the prescribing habits of physicians regarding extended-use oral contraceptives (OC) and medically induced amenorrhea. Study Design: Practice characteristics, contraceptive prescription habits, menstrual cycle physiology knowledge and attitudes about medically induced amenorrhea of Oregon obstetrics and gynecology (OBGYN) and family medicine physicians were assessed using either a cross-sectional postal or electronic mail survey. Attitudes were assessed using a series of Likert-style questions; multiple-choice responses were used to evaluate knowledge and prescribing habits. Results: Of the 713 physicians in the sample (email 575, paper 138), 233 returned the survey, for an overall response rate of 32.7%. Over 90% (211/233) of respondents prescribed OCs; of these, 73.9% (155/211) stated that they prescribed extended-use OCs either often (23.5%) or sometimes (50.5%). Without adjusting for other factors, physicians reporting an OBGYN specialty (odds ratio [OR] 8.02, 95% confidence interval [CI]: 3.40-18.91) or an urban practice location (OR 2.75, 95% CI: 1.42-5.30) were more likely to report prescribing extended-use OCs. However, after adjusting for other factors, attitude was the only factor which remained significantly associated with prescribing (OR 1.85, 95% CI 1.41-2.42). Conclusion: Physicians' attitudes regarding medically induced amenorrhea influence the use of extended-cycle OC more than any other characteristic.