How to Provide Sexual and Reproductive Health Care to Patients: Focus Groups With Rheumatologists and Rheumatology Advanced Practice Providers

Objective. Rheumatologists have identified challenges to providing sexual and reproductive health (SRH) care to patients with gestational capacity. We conducted focus groups with rheumatologists and rheuma-tology advanced practice providers (APPs) to elicit their solutions to overcoming barriers to SRH care.Methods. Qualitative focus groups were conducted with rheumatologists (3 groups) and APPs (2 groups) using videoconferencing. Discussions were transcribed and 2 trained research coordinators developed a con-tent-based codebook. The coordinators applied the codebook to transcripts, and discrepancies were adjudi-cated to full agreement. The codes were synthesized and used to conduct a thematic analysis. Differences in codes were also identified between the clinician groups by provider type.Results. A total of 22 clinicians were included in the sample, including 12 rheumatologists and 10 APPs. Four themes emerged: (1) clinicians recommended preparing patients to engage in SRH conversations before and during clinic visits; (2) consultation systems are needed to facilitate rapid SRH care with women's health providers; (3) clinicians advised development of training opportunities and easy-to-access resources to address SRH knowledge gaps; and (4) clinicians recommended that educational materials about SRH in the rheumatology context are provided for patients. Although similar ideas were generated between the APP and rheumatologist groups, the rheumatologists were generally more interested in additional training and education, whereas APPs were more interested in electronic health record prompts and tools.Conclusion. Providers identified many potential solutions and facilitators to enhancing SRH care in rheuma-tology that might serve as a foundation for intervention development.

Automated summary

Rheumatologists and rheumatology advanced practice providers generated potential solutions to overcoming barriers to sexual and reproductive health (SRH) care through focus group discussions. Recommendations included preparing patients for SRH conversations, establishing consultation systems for rapid SRH care, developing training opportunities and accessible resources, and providing educational materials in the rheumatology context. Different preferences were identified between rheumatologists and APPs regarding additional training and education versus electronic health record prompts and tools.