Ab1613-HPR an Audit on Contraception Conversations With Lupus and CTD Patients

Background: In patients with systemic lupus erythematosus (SLE) and connective tissue diseases (CTDs), the importance of inquiring about contraception with women of child-bearing age is paramount. Many medications used in the treatment of these conditions pose teratogenic risks, as does high disease activity, emphasizing the need for proactive discussion. This audit explores the frequency of such inquiries, aiming to highlight the critical intersection of reproductive health and rheumatologic care. By fostering early and regular conversations on contraception, we can strive to minimize risks, empower patients, and enhance the overall safety and well-being of women with Rheumatic disease. Objectives: This audit endeavours to assess the frequency of contraception discussions in women of child-bearing age who carry a diagnosis of SLE or CTD. By examining current practice, our goal is to target areas for improvement and reinforce the importance of proactive contraceptive inquiries. Ultimately, we aim to enhance patient safety by ensuring comprehensive reproductive health conversations within the realm of rheumatologic care. Methods: This audit focused on patients attending a SLE/CTD clinic in a tertiary referral centre in Ireland between 2020 and 2023. The initial database contained 192 patients of various ages, genders and diagnoses. Data was anonymized and the scope was narrowed to women of child-bearing age with a diagnosis of either SLE, CTD, SLE/CTD overlap or other SLE overlap syndromes. 31 patients met these criteria. Clinic letters and medical charts were examined to determine if contraception discussions had taken place or were documented during consultations. Current medication and alterations to therapy were identified. Most patients were either on hydroxychloroquine alone or a mix of hydroxychloroquine and another agent. Results: Upon reviewing records of the 31 selected patients, only 6 patients had had documented discussions with their physician in relation to contraception in the last 3 years. Only 3 of these 6 patient were taking contraception. Notably, all 6 patients had a diagnosis of SLE. 4 out of the 6 patients who were asked about contraception were concurrently prescribed teratogenic medication. Of the 25 patients not asked about contraception, 9 were prescribed teratogenic medication. Conclusion: The findings of this audit underscore a critical gap in addressing reproductive health, particularly for those at an elevated risk due to both their diagnosis and the medications integral to their treatment. Addressing this discrepancy is imperative for optimizing patient safety and well-being. REFERENCES: [1] Andreoli L, et al. EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis. 2017 Mar;76(3):476-485. Acknowledgements: NIL. Disclosure of Interests: None declared.