Assessment of the Quality of Family Planning Counseling Interventionsin Female Solid Organ Transplant Patients

Abstract

Objective: To evaluate if women were educated on the potential risks of unplanned post-transplant pregnancy and if the chart had documentation of contraception use and family planning discussions in solid organ transplant (SOT) patients at a major tertiary referral academic transplant center. Methods: This quality improvement study was a retrospective chart review of female patients at SOT center. An anonymous survey to identify potential knowledge gaps regarding post-transplant pregnancy risk was given to health care providers. Result: A total of 62 out of 208 patient charts were screened and included in the study. Exclusions included male gender or not being of child-bearing potential. In the 62 charts, 1.6% had documentation for an oral contraception prescription, 1.6% received instruction to utilize barrier contraception, 3.3% received an intrauterine device (IUD), and 11.5% received surgical sterilization. There was no documentation of any method of contraception in 84% of the charts. There was documented counseling on the teratogenic effects of mycophenolate in 98% of the patient charts, however none had documented counseling on the maternal or fetal risk of pregnancy within two-years post-transplant. There was a 35% response rate to the healthcare provider survey with majority understood and counseled post-transplant regarding the importance of contraception. Conclusion: This study demonstrated that there is an opportunity to address a lack of definitive family planning counseling, potentially by developing a multi-disciplinary approach. By utilizing all the resources and expertise of the multi-disciplinary team, this could improve the quality of patient education and reduce the risk of unplanned pregnancies in the female post-transplant population.