Background/Purpose: While rheumatologists in several descriptive studies have acknowledged the importance of family planning in their care of women with rheumatic diseases, they have also identified key barriers to this care, including time constraints, competing priorities, and inadequate communication with women’s health providers. We conducted a series of focus groups composed of rheumatologists and rheumatology advanced practice providers (APPs) to synthesize their ideas for potential tools and solutions to overcome these barriers within the rheumatology clinical setting.

Methods: Semi-structured qualitative focus groups were conducted with rheumatologists (N=3 groups) and APPs (N=2 groups). Trained independent qualitative analysts conducted the focus groups via Zoom video conferencing. Discussions were transcribed and two trained research coordinators developed a content-based codebook. They applied the codebook to transcripts, and discrepancies adjudicated to full agreement with the principal investigator. Differences in codes between the groups by provider type were also identified. The codes were synthesized and used to conduct a thematic analysis.

Results: A total of 22 clinicians participated in the study, most of whom were women (75%) working within academic practice settings (60%). Clinicians had practiced rheumatology for an average of six years (range 1-17 years). Four themes emerged from the focus groups: 1) Clinicians desired patient-directed tools and resources to educate and prepare patients to discuss reproductive health issues at the rheumatology visit; 2) Most clinicians were aware of existing reproductive health resources, but desired additional training or resources around contraception and medication safety; 3) Clinicians desired tools to facilitate contact with women’s health providers to ensure early and uncomplicated access to reproductive health care (e.g., electronic consults); 4) Clinicians were less interested in using electronic health record (EHR) pop-up reminders or alerts to support family planning care, but more interested in using prepopulated text within the EHR to include in patient notes or educational information to add to patient visit summaries. Although similar ideas were generated between the APP and rheumatologist groups, the rheumatologists were generally more interested in additional training and education, whereas APPs were more interested in EHR prompts and tools.

Conclusion: In this study, rheumatologists and rheumatology APPs from primarily academic practice settings described tools and resources that could help them to provide more consistent and higher-quality family planning care to patients with childbearing potential. Future work should focus on the development of patient-facing tools and resources to prepare patients for family planning conversations with rheumatology clinicians. Additional educational resources are needed to address providers’ knowledge gaps around contraception and medication safety in the context of pregnancy. Finally, individual health systems and practices need to prioritize the development of accessible pathways to reproductive health care for women with rheumatic disease.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/providing-high-quality-family-care-planning-for-women-with-rheumatic-disease-in-rheumatology-clinics-perspectives-of-rheumatology-clinicians/