A fifth of all indemnity cases related to contraception prescribed by GPs are related to commonly known complications, according to a new review by the Medical Defence Union (MDU).
Out of 161 cases related to contraception prescribed by GPs between 2014 and 2016, 30 cases related to a recognised condition such as a deep vein thrombosis, pulmonary embolism or infection.
Other reasons for cases included mixing up the names of a commonly used contraceptive injection with a steroid injection leading to a medication error, contraceptive implants being incorrectly sited and a failure by the doctor to exclude pregnancy before prescribing contraception.
The MDU said that doctors can help to minimise contraceptive prescribing risks by taking simple precautions including discussing risks and side effects of available treatments with patients, and taking a careful menstrual and sexual history to assess the risk of an existing pregnancy.
Dr Beverley Ward, MDU medico-legal adviser, said: ‘This analysis demonstrates that there are risks involved in prescribing contraception, and in a few cases patients can come to harm.
‘It is essential that doctors providing these treatments to mostly young and healthy patients, bear in mind the risk of complications. It’s also important for doctors to ensure they are appropriately trained and regularly update their skills, especially when performing invasive procedures such as inserting contraceptive implants.’
Out of the 161 cases dealth with by MDU between 2014 and 2016, 48 resulted in compensation claims, with many relating to contraceptive implants, and 67 complaints, the highest number relating to the contraceptive pill or patch.
Advice to GPs prescribing contraception
- Discuss carefully with patients what treatments are available, and in particular the risks and side effects of each when getting consent.
- Ensure that you are appropriately qualified in prescribing and performing any invasive procedures.
- Take care when administering injections to check the label carefully to prevent the administration of an incorrect drug.
- Take a careful sexual and menstrual history. This is important to assess the risk of an existing pregnancy before you provide contraception.
- Handle discussion of past history with sensitivity, expressing the need to ask personal questions.
- Document the discussion and ensure that the patient is aware of and understands the associated risks.