Qualité des soins primaires Libre accès

Abstrait

General practitioners’ attitudes towards the provision of services to young people aged under 16: a cross-sectional survey

Jane Bethea , Julia Hippisley-Cox , Carol Coupland , Mike Pringle

Objective This study aimed to further explore the findings of our previous study which found that general practices with young general practitioners (GPs) and female GPs had lower teenage pregnancy rates (in women aged 13–19 years) and,spe cifically, to identify associations between responses to questions relating to the care of young teenagers and the age and sex of the respondent.Design Cross-sectional survey of 621 GPs.Setting Primary care,in the former Trent region of England.Methods A questionnaire was sent to all GPs in four areas within what was the Trent Health region. These were chosen to represent areas with high (Barnsley and Doncaster),moder ate (Sheffield) and low (Lincolnshire) teenage pregnancy rates. Main outcomes measures Responses to questions concerning the provision of contraception to young teenagers,referral for termination in this age group, and also issues around confidentiality and their associations with the age and sex of the GP respondent.Results Older GPs (aged 49 and over) were less likely than younger GPs (aged under 36 years) to prescribe contraception to young women aged under 16 years without parental consent (odds ratio (OR) 0.55; 95% confidence interval (CI) 0.33 to 0.93). They were also more likely to state that a parent or guardian could have access to the content of a consultation without the consent of the youngperson (OR 2.35; 95% CI 1.07 to 5.18),a nd to report that they rarely or never saw their young patients without a parent or guardian present (OR 1.97; 95% CI 1.10 to 3.53). The GPs in the older age group were more likely than those aged under 36 years to stateeither that they did not know if it was legal to prescribe contraception to young people aged under 16 years,or that it was illegal to do so (OR 4.27; 95% CI 1.50 to 12.22).Conclusions Our previous study found that lower teenage pregnancy rates are associated with practices with young GPs and female GPs. This study has found that younger GPs are more likely to prescribe contraception without parental consent,and are  also more likely to believe that a consultation between a GP and young person is confidential. This is likely to affect how accessible and acceptable young people view primary care services to be,and may also impact on their decision to consult with their GP to discuss contraception and sexual health issues.