Hum. Reprod. Advance Access originally published online on February 17, 2009
Human Reproduction 2009 24(6):1420-1426; doi:10.1093/humrep/dep029
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Information provision in fertility care: a call for improvement
1 Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands 2 Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Nijmegen Medical Centre, PO Box 9101 6500 HB, Nijmegen, The Netherlands 3 Department of Obstetrics and Gynaecology, St Antonius Hospital, PO Box 2500, 3430 EM, Nieuwegein, The Netherlands
4 Correspondence address. E-mail: s.mourad{at}iq.umcn.nl
BACKGROUND: Adequate information provision is a crucial dimension of high-quality fertility care. Clinical practice guidelines containing consensus-based recommendations may standardize practice between settings. This study was designed for three purposes: (i) to assess actual adherence to recommendations on information provision, (ii) to measure patient satisfaction with current practice and (iii) to analyse how variation in adherence relates to the characteristics of patients and clinics.
METHODS: All recommendations concerning patient information were extracted from 10 national fertility guidelines and edited into a patient questionnaire. Additional questions concerning patient satisfaction and potential determinants of information provision at patient level were included. A total of 2698 couples from 16 clinics were invited to participate. A professional’s questionnaire was sent to all gynaecologists to gather potential determinants at clinic level. Multilevel regression analysis was performed to identify the determinants of information provision.
RESULTS: A total of 1499 couples (56%) participated. The percentage of couples who reported to have received complete information varied between recommendations from 10 to 96% (mean 57%). Overall, 94% of couples were satisfied with fertility services. The use of checklists for information provision, the presence of obstetrics/gynaecology residents and specialized nursing personnel, and higher patient anxiety scores were significantly associated (P < 0.05) with higher levels of information received.
CONCLUSIONS: Despite the possibility of recall bias in questionnaire studies and observed high patient satisfaction with fertility services, we conclude that information provision for infertile couples is currently poor and in need of improvement. This could easily be procured by, for example, the use of information checklists.
Key words: information provision/clinical practice guidelines/counselling/infertility
Submitted on October 13, 2008; resubmitted on December 23, 2008; accepted on January 22, 2009.