Institute of Epidemiology & Health Care


Departmental Seminar - Impact of financial incentives to give LARC advice in general practice.


Dr Richard Ma - GP principal in Islington and an NIHR Doctoral Research Fellow based at the Department of Primary Care and Public Health, Imperial College London. His main research interest is in improving access and delivery of sexual and reproductive healthcare in UK general practice.


What is the impact of offering financial incentives to give long acting reversible contraception (LARC) advice in general practice? An interrupted time series study using electronic health records.


Timely access to effective contraception is part of a broader strategy to reduce unplanned pregnancies. National Institute for Health and Clinical Excellence (NICE) recommends long active reversible contraception (LARC)  because it is cost-effective. In 2004, a new contract was introduced in UK general practice which used financial incentives to improve quality of care. A target was introduced in 2009 for general practitioners (GPs) to give LARC advice to women attending for contraceptive care.

We conducted an interrupted time series study using Clinical Practice Research Datalink (CRPD) - database of electronic health records (EHRs) extracted from participating general practices in the UK – to examine the impact of this financial incentive on LARC prescriptions issued in general practice and abortion rates, before and after this was introduced in 2009.

While a large database such as CPRD can offer a large sample size broadly representative of the UK population, using “real life” data on consultations and activities, EHRs are not primarily designed with epidemiological research in mind, so the data needs to be examined carefully for meaningful interpretation.

Apart from some exciting study findings, I will also share with you my experience of working with CPRD and Stata programming as an early career researcher, including what I wished I had known before downloading a dataset containing records of just over 3 million patients …”