Rural women’s health receives boost

The Monash University-led ORIENT study aims to deliver better access to sexual and reproductive health services in primary care.
 
As part of the NHMRC Centre of Research Excellence in Sexual and Reproductive Health for Women in Primary Care (SPHERE), ORIENT has received a $1.9 million Medical Research Future Fund (MRFF) Primary Health Care Research grant.
 
The five-year project will test the efficacy and cost-effectiveness of a nurse-led model of care in general practice, to increase long-acting reversible contraception (LARC) uptake and improve access to early medical abortion services in rural and regional areas.
 
‘We are delighted to receive this funding, particularly ahead of Women’s Health Week, to help build upon initiatives of research excellence to support primary care more broadly across Australia, to deliver quality women’s healthcare,’ Professor Danielle Mazza, ORIENT project lead and Head of Monash University’s Department of General Practice, told newsGP.
 
The MRFF research grant addresses two key healthcare research priorities: rural and regional access to women’s health services, and workforce issues, including scope of practice.
 
For women living in rural and regional areas, access to LARC – implants and intrauterine devices – and abortion services can present challenges compared to those living in metropolitan areas.
 
This is mainly due to geographical isolation and lack of services, according to the ORIENT research team, who are aiming to address this through innovative workforce solutions involving nurse-led models of care, task-sharing and telehealth.
 
‘The ORIENT study looks at [the fact that] the area of women’s access to LARC and medical abortion in rural and regional areas is critical, because these women are 1.4 times more likely to experience an unintended pregnancy,’ Professor Mazza said.
 
Evidence points to the role of LARCs as the most effective way of preventing unintended pregnancies, but the ORIENT researchers identify that current uptake among Australian women is low.
 
Targeting a key goal of the National Women’s Health Strategy 2020–30 and addressing community and stakeholder calls for greater access to these services, the ORIENT team seeks to broaden the scope of work of practice nurses to address these needs.
 
‘We identified that practice nurses enjoy working in women’s health, and how we can support them to better deliver these services through general practice,’ Professor Mazza said.
 
‘In the current [pandemic] environment, we are looking at the cost effectiveness of telehealth. The ORIENT study will examine how we can utilise nurse-led models of care, which has been a somewhat bone of contention during COVID, with nurses unable to access MBS items with telehealth.
 
‘The trial recruits general practices through rural and regional areas, offering GPs and practice nurses extra training and support online to set up services in their practices locally, and we will support them through that process.’
 
All ORIENT participants will eventually receive the intervention. The researchers will first determine how to implement the new models of care, allow access, then measure the before and after.
 
Professor Mazza says the study will help to inform government policy around nurse-led models of care, which echoes the MRRF’s calls for improved workforce issues and scope of practice.
 
‘We hope our outcomes will increase LARC uptake and medical abortion in rural and remote communities,’ she said.
 
The multidisciplinary ORIENT team comprises leading Australian and international researchers, in collaboration with patients and key primary care and rural sexual health stakeholders. These include the RACGP, Australian College of Rural and Remote Medicine, Australian Primary Health Care Nurses Association, and family planning organisations.
 
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abortion LARC research rural health women’s health