Contraceptive Counselling and Prescribing Practices for Women With Chronic Diseases: A Mixed-methods Study Protocol in Malaysian Primary Care
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Abstract
Introduction: Safe and effective contraception is crucial for women with chronic diseases, who face higher pregnancy-related risks such as congenital anomalies and preterm births. Primary care doctors, as the first point of contact, play a critical role in contraceptive counselling and prescribing. However, the factors influencing their practices, particularly in Malaysia, remain underexplored. This study aims to identify factors associated with contraceptive counselling and prescribing for women of reproductive age with chronic diseases among primary care doctors in Peninsular Malaysia. Methods: A concurrent mixed-methods design will be used. Phase 1 involves the development and validation of a self-administered questionnaire. Phase 2 consists of a cross-sectional survey among approximately 660 doctors, using the validated questionnaire distributed via REDCap platform, and qualitative exploration through 20 online focus group discussions (FGDs) analysed using NVivo. Independent variables include sociodemographic characteristics, contraceptive-related experience, knowledge, and attitudes; dependent variables are counselling and prescribing practices. Quantitative and qualitative data will be integrated during interpretation stage to provide a comprehensive understanding of influencing factors. Discussion: The study will generate evidence on provider-side determinants of contraceptive care, informing national training modules, clinical guidelines, and policy interventions. Findings will support the refinement of existing continuing medical education (CME) and LPPKN programs, helping tailor capacity-building efforts. Ultimately, this may improve access to appropriate contraceptive counselling and reduce adverse reproductive outcomes among women with chronic diseases in Malaysian primary care. Trial Registration: This trial has received approval from the National Medical Research Registration of Malaysia (NMRR) (NMRR ID-24-03525-REG).
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