The ORIENT Study

Australian women living in rural and regional areas experience many barriers to accessing long-acting reversible contraception (LARC) and early medical abortion (EMA) services.

ORIENT (ImprOving Rural and regIonal accEss to long-acting reversible contraceptioN and medical abortion through nurse-led models of care, Tasksharing and telehealth) is a stepped-wedge pragmatic cluster-randomised controlled trial which aims to assess the effectiveness of a nurse-led model of care in general practice at increasing uptake of LARC and improving access to medical abortion in rural and regional areas.

The nurse-led model of care was co-designed with consumers and women’s health professionals, ensuring that the intervention can meet consumer needs, is evidence-based, feasible, sustainable and offers the best chance of success. Practices were randomised to implement the model sequentially, with the comparator being usual care. All practices received implementation support including:

• Free online accredited LARC and EMA training
• An online educational outreach session to discuss practical strategies for implementing the nurse-led model, tailored to each practice
• Enrolment into the AusCAPPS Network, an Australia-wide virtual community of practice that connects EMA and LARC providers through peer-networking opportunities and access to resources and training
• Reimbursement and continuing professional development points

We are in the final phases of the study and are currently undertaking the process evaluation and health economic evaluation (2025/26).