Choosing the right contraceptive method – development of a clinical pathway

Choosing the right contraceptive method – development of a

clinical pathway 

A Mendelin

Grünenthal GmbH, Aachen, Germany 

A first

International Belara® Advisory Board Meeting has been initiated (11/ 2005) to

improve contraceptive management in clinical practice by conceiving an

innovative methodology to guide gynaecologists in their decisions making in

contraception. For this purpose the advisory board started its work on clinical

pathways in contraception. 

Clinical pathways are broadly well accepted tools,

helping physicians to implement clinical guidelines into their day to day

practise. This workshop tries to give guidance to doctors to reflect their daily

routine procedures in contraception on professional level and to support them to

make clinical decisions more effective in terms of finding optimized and

individual contraceptive strategies for women. To our knowledge such tools

momentarily do not exist or exist only in a rudimentary version. Efficacy data

from clinical and highly controlled studies, often displayed in “evidence

based guidelines” have to be connected with the professional’s subjective

experience of effectiveness in daily practice. Professional’s and patient’s

subjective experiences of effectiveness in clinical practice have to be

evaluated, formulated as educated guesses and integrated into guidelines. 

Clinical pathways can help to integrate and weight that guideline content in the

clinical decision process of daily routine practice. They can help to reflect

the effectiveness of such content in its regards to contraceptive effectiveness,

safety, manageability, tolerability, etc.. All these are quality criteria which

are more crucial in contraception because gynaecologists are not facing patients

who suffer from a disease, but healthy women who come to ask for a contraceptive

method. Therefore, given the importance of women’s individual expectancies and

needs in contraception therapeutic choices, a clinical pathway giving room for

reflection of individual choices based on evidence is definitely much more

relevant and effective in contraception than stricter guidelines or basic

decision trees which are mainly ignored.

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