The State Of Fertility Preservation Counseling For Women With Cystic Fibrosis Reported By Cystic Fibrosis Providers.

Fertility preservation (FP) counseling is part of comprehensive care provided to women of childbearing age undergoing oncologic treatments; however, this is not standard for patient populations with other chronic conditions. The purpose of this study was to examine the current state of FP counseling for women with cystic fibrosis (CF) from the perspective of their healthcare providers, with the goal of identifying the gaps, barriers, and facilitators to implementation of counseling in clinical practice. This knowledge can lead to the development of FP guidelines for women with CF and enhance shared decision making by broadening their reproductive options. This study utilized a quantitative, exploratory, cross-sectional design. Healthcare providers (e.g., physicians, nurse practitioners, clinic coordinators, pharmacists, social workers, nurses) were recruited from CF Foundation accredited clinics throughout the United States and via snowball sampling. Participants completed a web-based, anonymous FP survey with 39 items that took approximately 30 minutes to complete. Participants received $20 for their participation. The descriptive statistics were provided using R software. Fifty healthcare providers completed the survey (Mage= 40.8, SD=11.1). The majority of the healthcare providers were female (n=45). Despite the fact that 92% (n=46) of the providers felt that FP discussions should be standard for all female patients with CF, 28% (n=14) of providers reported that FP topics were not discussed with female patients with CF at any age. Most providers felt that initiation of FP discussions was the responsibility of the healthcare team (n=34), but some felt that patients should initiate the FP discussions (n=11). Lack of knowledge (n=17) and lack of time (n=12) were the two most substantial barriers to FP discussions by healthcare providers. According to the providers, the two best facilitators for FP discussions in clinic would be having national guidelines or standards (n=41) and integrating partnerships with sexual and reproductive health specialists (n=39) as part of comprehensive CF care delivery. Having educational materials to foster FP discussions between providers and patients was another facilitator reported (n=50). Healthcare providers preferred having educational information and resources shared via online format (n=46) and written pamphlets (n=44). Fertility preservation counseling is an important part of comprehensive care for women with CF; however, many women do not receive FP information. This national sample of CF healthcare providers reported that they lacked the knowledge and time to discuss FP with their patients. Removing the barriers and optimizing the facilitators to encourage FP discussions between women with CF and their providers will broaden these women’s reproductive options by facilitating fully informed decision making to improve overall health outcomes.