<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-5830</journal-id>
<journal-title><![CDATA[Acta Obstétrica e Ginecológica Portuguesa]]></journal-title>
<abbrev-journal-title><![CDATA[Acta Obstet Ginecol Port]]></abbrev-journal-title>
<issn>1646-5830</issn>
<publisher>
<publisher-name><![CDATA[Euromédice, Edições Médicas Lda.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-58302022000200095</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Long-acting reversible contraceptive practices in northern portuguese primary health care: cross sectional study]]></article-title>
<article-title xml:lang="pt"><![CDATA[Práticas de contraceção reversível de longa duração nos Cuidados de Saúde Primários do Norte de Portugal: estudo transversal]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Reis]]></surname>
<given-names><![CDATA[Maria João Marques]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sá]]></surname>
<given-names><![CDATA[Luísa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,University of Porto Faculty of Medicine ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,University of Porto Faculty of Medicine Family Medicine Unit, Social Sciences and Health Department and, Centre for Research in Health Technologies and Information Systems]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Family Health Unit Nova Via  ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>06</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>06</month>
<year>2022</year>
</pub-date>
<volume>16</volume>
<numero>2</numero>
<fpage>95</fpage>
<lpage>114</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-58302022000200095&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-58302022000200095&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-58302022000200095&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Overview and Aims:  LARCs (long-acting reversible contraceptives) are long-term contraceptives suitable for all women, not dependent on use, with high contraceptive efficacy, satisfaction, and continuity by users. In Portugal, LARCs are free of charge in Primary Health Care and their placement is part of the family physicians' skills. The present study aimed to characterize contraceptive practices and LARCs prescribing and placement in the Northern Regional Health Administration of Portugal.  Study Design:  Cross-sectional study.  Population:  Specialists and trainees family physicians from Northern Portuguese Primary Health Care  Methods:  We used a non-random, &#8220;snowball&#8221; sample, disseminated via social networks and supported by health care institutions and professional organizations.  Results:  We obtained a sample of 167 participants, corresponding to 5.9% of the Northern Portuguese Primary Care family physicians, which represents 26.2% of the health units and 23 of the 24 Groups of Primary Care Centres of this region. Estroprogestative pills lead the contraceptive recommendation (84,4%; 95%CI: 78,5% - 89,8%), followed by LARCs (21,6%; 95%CI: 15,6% - 28,1%). The subcutaneous implant was the most recommended (74,9%; 95%CI: 68,3% - 80,8%) and placed LARC (70,7%; 95%CI: 62,9% - 77,8%). Most family physicians do not place Intrauterine contraceptives (59,9%; 95%CI: 52,1% - 67,1%), opting to refer to a gynecologist. The subcutaneous implant tends to be recommended for nulliparous (p &lt; 0,001) and Intrauterine contraception for multiparous women (p &lt; 0,001).  Conclusions:  There is a paradigm shift in contraception in Northern Portuguese Primary Health Care, with the increased use of LARCs. In this region, subcutaneous Implant represents the most commonly used LARC, opposing the global tendency where Intrauterine contraception is the LARC of choice. Intrauterine LARCs appear to be more dependent on external barriers than family physicians competence. Apart from decreasing hospital referrals, improving LARC placement conditions could optimize the use of Intrauterine contraception and users&#8217; sexual health.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução e objetivo:  Os LARC (long-acting reversible contraceptives) são anticoncecionais de longa duração, adequados a todas as mulheres, não dependentes de uso, com elevada eficácia contracetiva, satisfação e continuidade pelas utilizadoras. Em Portugal, os LARCs são gratuitos nos Cuidados de Saúde Primários e a sua colocação faz parte das competências dos médicos de família. Este estudo pretendeu caracterizar as práticas contracetivas e o perfil de prescrição e colocação de LARCs na Administração Regional de Saúde do Norte de Portugal.  Desenho do estudo:  Estudo observacional transversal.  População:  Especialistas e Internos de formação específica em Medicina Geral e Familiar dos Cuidados de Saúde Primários da região Norte de Portugal.  Métodos:  Foi utilizada uma amostra tipo &#8220;bola de neve&#8221;, divulgado através de redes sociais e apoiado por instituições de saúde e organizações profissionais.  Resultados:  Obtivemos uma amostra de 167 participantes, correspondente a 5,9% dos médicos de família dos Cuidados Primários do Norte de Portugal, representando 26,2% das unidades de saúde e 23 dos 24 Grupos de Centros de Cuidados Primários desta região. Os Estroprogestativos orais lideram a recomendação contracetiva nos Cuidados de Saúde Primários do Norte de Portugal (84,4%; IC95%: 78,5% - 89,8%), seguidos pelos LARCs (21,6%; IC95%: 15,6% - 28,1%). O implante subcutâneo foi o LARC mais aconselhado (74,9%; IC95%: 68,3% - 80,8%) e colocado (70,7%; IC95%: 62,9% - 77,8%). A maioria não coloca contracetivos intrauterinos (59,9%; IC95%: 52,1% - 67,1%), optando por referenciar as utentes para consulta de ginecologia. O implante subcutâneo tende a ser aconselhado a nulíparas (p &lt; 0,001) e a contraceção intrauterina a multíparas (p &lt; 0,001).  Conclusões:  Existe uma mudança de paradigma na contraceção nos Cuidados de Saúde Primários do Norte de Portugal, com o aumento do uso de LARCs. Nesta região, o implante subcutâneo representa o LARC mais utilizado, opondo-se à tendência global em que a contraceção intrauterina é o LARC de escolha. Os LARC intrauterinos parecem ser mais dependentes de barreiras externas do que da competência dos médicos de família. Além de diminuir as referências hospitalares, a melhoria das condições de colocação dos LARC poderia otimizar a utilização da contraceção intrauterina e a saúde sexual dos utilizadores.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Contraceptive devices]]></kwd>
<kwd lng="en"><![CDATA[Contraceptive agents]]></kwd>
<kwd lng="en"><![CDATA[Long-acting reversible contraception]]></kwd>
<kwd lng="en"><![CDATA[Primary Health Care]]></kwd>
<kwd lng="pt"><![CDATA[Dispositivos anticoncepcionais]]></kwd>
<kwd lng="pt"><![CDATA[Métodos de contraceção]]></kwd>
<kwd lng="pt"><![CDATA[Contraceção reversível de longa duração]]></kwd>
<kwd lng="pt"><![CDATA[Cuidados de Saúde Primários]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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