People with rheumatologic diseases often receive conflicting advice about family planning from physicians. Inspired by her family’s and patient’s experiences, Dr. Karlsen and collaborators surveyed IM residents to determine their understanding on the safety of using immunosuppressive and immunomodulatory medications in pregnancy.
In addition, she evaluated residents’ knowledge of the safety and efficacy of contraceptive options in individuals with Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Antiphospholipid antibody syndrome (APS).
Framework
Using the results and American College of Rheumatology Guidelines, Dr. Karlsen designed a framework providers can use for reviewing medications and ordering lab work during preconception visits.
The framework also helps providers determine the safety of various contraceptive options in this patient population. Dr. Karlsen educated IM residents on the framework at a didactic session.
Assessment
She assessed attendees’ perspectives and knowledge using paired pre/ post-workshop surveys. Fifteen residents completed pre and post-workshop surveys (65% response rate).
The proportion of respondents who Agreed/Strongly Agreed that they were capable of counseling on contraceptive options increased from 7% to 80%.
The proportion who would offer emergency contraception to a patient with APS increased from 53% to 80%. Other measured aspects of knowledge also improved.
“This project blended my interests in medical education, women’s health, contraceptive access, and connective tissue diseases. It is important that people with rheumatologic diseases be counseled on inclusive options to meet their family planning goals.”
Next year, Dr. Karlsen will work as a primary care physician in the greater Seattle area. She hopes to disseminate her framework teaching materials by publishing in a peer-reviewed portal for educational materials (MedEd PORTAL).
Dr. Karlsen acknowledges her mentor, Dr. Adelaide (Addie) McClintock, and their collaborator Lynly Beard, Research Impact & Social Work Librarian. She thanks resident participants and Academic Half Day organizers.