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Sütcüoğlu BM, Güler M. Social Media Videos on Contraceptive Implants: An Assessment of Video Quality and Reliability. J Pediatr Adolesc Gynecol 2024; 37:39-44. [PMID: 37634871 DOI: 10.1016/j.jpag.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
STUDY OBJECTIVE There are many videos on contraception on YouTube and TikTok, and women around the world use video platforms extensively to seek health information from videos of uncertain reliability and quality. The main objective of this research was to evaluate the scientific reliability and quality of the most popular social media videos about contraceptive subdermal implants. METHODS TikTok and YouTube videos were assessed separately by two gynecologists. The video quality was evaluated according to the DISCERN score, modified DISCERN score, and Global Quality Scale (GQS) score. RESULTS The study included the 100 most popular videos, 44 of which were uploaded by health care professionals. The median DISCERN score for videos shared by health care professionals was 50 (range 15-75), whereas it was 22 (range 15-56) for videos shared by independent users (P < .001). The median modified DISCERN score was 4 (min-max 0-5), and the median GQS score was 4 (min-max 1-5) for the videos uploaded by health care professionals. The modified DISCERN and GQS scores of TikTok videos were lower than those of YouTube videos (both P < .001). CONCLUSION Social media videos about contraceptive subdermal implants are popular and have been viewed tens of thousands of times, but the overall medical validity, which we evaluated according to the scoring systems, was poor. Despite the large number of videos, the content's quality and reliability are quite limited. There is a need to prioritize the education provided to patients by gynecologists, as well as to create high-quality content for YouTube and other similar platforms.
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Affiliation(s)
| | - Melike Güler
- Lokman Hekim University, Department of Obstetrics and Gynaecology, Ankara, Turkey
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Gashaye KT, Gebresilassie KY, Kassie BA, Zenebe CB, Mengistu Z, Ferede SE, Andualem Z, Merid MW, Taddese AA, Abera M. Reasons for modern contraceptives choice and long-acting reversible contraceptives early removal in Amhara Region, Northwest Ethiopia; qualitative approach. BMC Womens Health 2023; 23:273. [PMID: 37208658 DOI: 10.1186/s12905-023-02375-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/18/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Women use modern contraceptive methods, mainly either to limit or space pregnancy and both are not identical in their choices. One method may not best fit an individual's need irrespective of the time of spacing. Cognizant of this, the context with which women base in choice of contraceptives, their lived experiences in using, and factors for early removal/ discontinuation of long-acting reversible contraceptives (LARCs) are not much investigated in the study setting and our study aimed to bridge the gap through exploring the underlying reasons. METHOD A phenomenological study design was used to explore sampled women's reasons and experiences. Reproductive-aged women (15-49 years) who removed long-acting methods in the past 6 months were included. A criterion sampling approach was employed to recruit study participants. Data was collected using an interview guide for in-depth (IDIs) and key informant interviews and were tape-recorded with interviewees' consent. Audio data were transcribed verbatim and translated into English. The data was first saved in plain text format and imported into Atlas.ti 7.0 software to facilitate coding and categorizing. The content analysis method was used to classify, organize data, and interpret the qualitative data according to key categories. RESULTS Several misconceptions about contraceptives (e.g., implants are not appropriate for daily laborers, women who use contraceptives (such as injectables) can only bear girl-child, etc.) were reported by clients and health providers. These misconceptions might not have scientific merit but they are powerful enough to affect actual behaviors toward contraceptives, including early removal. The awareness, attitude, and use of contraceptives tend to be lower in rural areas. For premature removal of LARCs, side effects, and heavy menstrual bleeding, was the most commonly identified reason. The IUCD is the least preferred method and users said it is not comfortable during sex. CONCLUSION AND RECOMMENDATION Our study found different reasons and misconceptions for modern contraceptive methods' non-use and discontinuation. Standardized counseling approaches like the REDI (Rapport Building, Exploration, Decision Making, and Implementation) framework should be implemented in the country consistently. Some of the concrete providers' conceptions should be well-studied considering contextual factors to bring scientific evidence.
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Affiliation(s)
- Kiros Terefe Gashaye
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Belayneh Ayanaw Kassie
- Midwifery Directorate, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chernet Baye Zenebe
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zelalem Mengistu
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Emyu Ferede
- Department of RFPH, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zewudu Andualem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, Collège of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mehari W/Mariam Merid
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asefa Adimasu Taddese
- PhD Student, Department of Health Informatics /Biostatistics/, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mikyas Abera
- Department of Sociology, College of Social Science and Humanities, University of Gondar, Gondar, Ethiopia
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Palma F, Costa AR, Neves J, Pacheco A, Almeida MC, Bombas T, Silva DP. Perception of oral contraception – do women think differently from gynaecologists? EUR J CONTRACEP REPR 2023; 28:125-131. [PMID: 36971323 DOI: 10.1080/13625187.2023.2185482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
PURPOSE This study aimed to assess the experience and satisfaction with contraceptives and use of Combined Oral Contraceptives (COC) by women and compare their perceptions with those of gynaecologists. METHODS This was a multicentre survey study conducted in Portugal, during April and May, 2021 with women using contraceptives and gynaecologists. Online quantitative questionnaires were carried out. RESULTS A total of 1508 women and 100 gynaecologists were included. Cycle control was the pill non-contraceptive benefit most valued by gynaecologists and women. For gynaecologists, the main pill concern was the risk of thromboembolic events, but they believed that weight gain was the main concern for their patients. The pill was the most used contraceptive (70%) and women were largely (92%) satisfied. The pill was associated with health risks for 85% of users, mainly thrombosis (83%), weight gain (47%), and cancer (37%). The attributes of the pill most valued by women are contraceptive efficacy (82%), followed by low risk of thromboembolic events (68%), good cycle control (60%), non-interference with libido and mood (59%) and weight (53%). CONCLUSION Most women use contraceptive pills and are generally satisfied with their contraceptive. Cycle control was the most valued non-contraceptive benefit for gynaecologists and women, agreeing with physicians' beliefs about women. On the other hand, contrary to physicians' beliefs, that women's main concern is weight gain, women are mainly concerned with risks associated with contraceptives. Thromboembolic events are women's and gynaecologists most valued risk. Finally, this study indicates the need for physicians to better understand what COC users really fear.
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Yeh PT, Kautsar H, Kennedy CE, Gaffield ME. Values and preferences for contraception: A global systematic review. Contraception 2022; 111:3-21. [PMID: 35525287 PMCID: PMC9232836 DOI: 10.1016/j.contraception.2022.04.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To identify and synthesize original research on contraceptive user values, preferences, views, and concerns about specific family planning methods, as well as perspectives from health workers. STUDY DESIGN We conducted a systematic review of global contraceptive user values and preferences. We searched 10 electronic databases for qualitative and quantitative studies published from 2005 to 2020 and extracted data in duplicate using standard forms. RESULTS Overall, 423 original research articles from 93 countries among various groups of end-users and health workers in all 6 World Health Organization regions and all 4 World Bank income classification categories met inclusion criteria. Of these, 250 (59%) articles were from high-income countries, mostly from the United States of America (n = 139), the United Kingdom (n = 29), and Australia (n = 23). Quantitative methods were used in 269 articles, most often cross-sectional surveys (n = 190). Qualitative interviews were used in 116 articles and focus group discussions in 69 articles. The most commonly reported themes included side effects, effectiveness, and ease/frequency/duration of use. Interference in sex and partner relations, menstrual effects, reversibility, counseling/interactions with health workers, cost/availability, autonomy, and discreet use were also important. Users generally reported satisfaction with (and more accurate knowledge about) the methods they were using. CONCLUSIONS Contraceptive users have diverse values and preferences, although there is consistency in core themes across settings. Despite the large body of literature identified and relevance to person-centered care, varied reporting of findings limited robust synthesis and quantification of the review results.
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Affiliation(s)
- Ping Teresa Yeh
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Hunied Kautsar
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Caitlin E Kennedy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Mary E Gaffield
- Contraception and Fertility Care Team, Department of Sexual and Reproductive Health and Research, World Health Organization, Genève, Switzerland,Corresponding author.
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Schmidt NM, Hennig J, Munk AJL. Event-Related Potentials in Women on the Pill: Neural Correlates of Positive and Erotic Stimulus Processing in Oral Contraceptive Users. Front Neurosci 2022; 15:798823. [PMID: 35058744 PMCID: PMC8764149 DOI: 10.3389/fnins.2021.798823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background/Aims: Exposure toward positive emotional cues with - and without - reproductive significance plays a crucial role in daily life and regarding well-being as well as mental health. While possible adverse effects of oral contraceptive (OC) use on female mental and sexual health are widely discussed, neural processing of positive emotional stimuli has not been systematically investigated in association with OC use. Considering reported effects on mood, well-being and sexual function, and proposed associations with depression, it was hypothesized that OC users showed reduced neural reactivity toward positive and erotic emotional stimuli during early as well as later stages of emotional processing and also rated these stimuli as less pleasant and less arousing compared to naturally cycling (NC) women. Method: Sixty-two female subjects (29 NC and 33 OC) were assessed at three time points across the natural menstrual cycle and corresponding time points of the OC regimen. Early (early posterior negativity, EPN) and late (late positive potential, LPP) event-related potentials in reaction to positive, erotic and neutral stimuli were collected during an Emotional Picture Stroop Paradigm (EPSP). At each appointment, subjects provided saliva samples for analysis of gonadal steroid concentration. Valence and arousal ratings were collected at the last appointment. Results: Oral contraceptive users had significantly lower endogenous estradiol and progesterone concentrations compared to NC women. No significant group differences in either subjective stimulus evaluations or neural reactivity toward positive and erotic emotional stimuli were observed. For the OC group, LPP amplitudes in reaction to erotic vs. neutral pictures differed significantly between measurement times across the OC regimen. Discussion: In this study, no evidence regarding alterations of neural reactivity toward positive and erotic stimuli in OC users compared to NC was found. Possible confounding factors and lines for future research are elaborated and discussed.
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Affiliation(s)
- Norina M. Schmidt
- Department of Differential and Biological Psychology, University of Giessen, Giessen, Germany
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Nappi RE, Vermuyten N, Bannemerschult R. Missed opportunities in contraceptive counselling: findings from a European survey-based study with simulated patient consultation. EUR J CONTRACEP REPR 2021; 27:85-94. [PMID: 34860137 DOI: 10.1080/13625187.2021.2010040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Available evidence highlights unmet needs in contraceptive counselling practices. This study aimed to understand current practises and clinician behaviour across Europe. METHODS A novel, online approach was used to simulate contraceptive counselling discussions based on three, predefined patient types with a hidden need: poor compliance (patient X), headaches (Y) or desire for a hormone-free option (Z). Clinicians were asked to provide guidance about a contraceptive method for their randomly assigned patient at two time points: (1) after a simulated discussion, (2) after seeing a full patient profile. Descriptive statistical analyses included evaluation of the clinicians' counselling approach and a change in contraceptive recommendation thereof. RESULTS Out of 661 clinicians from 10 participating European countries, including obstetricians/gynaecologists, midwives and general practitioners, most failed to uncover patient X and Y's hidden needs (78.8% and 70.5%, respectively), whereas, 63.4% of clinicians uncovered patient Z's hidden need. Clinicians who uncovered their patients' hidden needs asked significantly more questions than those who did not (range of mean, 5.1-7.8 vs 1.5-2.2 respectively). Clinicians were more likely to recommend a change of prescription after seeing the full patient profile than after the simulated discussion (increase in prescription change, range: 12.3-30.2%), indicating that clinicians rely on patients speaking up proactively about any concerns. CONCLUSIONS Insufficient existing counselling practices result in missed opportunities for shared decision-making and discussion. Clinicians and contraceptive counselling services should empower women by introducing more in-depth contraceptive counselling, incorporating clear, open-ended questions, to improve patient adherence and enhance reproductive planning.
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Affiliation(s)
- Rossella E Nappi
- Research Centre for Reproductive Medicine, Gynaecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
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Long-Acting Reversible Contraceptive Attitudes and Acceptability in Adolescents and Young Adults: A Key to Patient-Centered Contraceptive Counseling. J Pediatr Adolesc Gynecol 2020; 33:673-680. [PMID: 32860948 PMCID: PMC8938958 DOI: 10.1016/j.jpag.2020.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/11/2020] [Accepted: 08/20/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE To examine the attitudes of adolescent and young adults (AYA) toward long-acting reversible contraception (LARC), and to assess how attitudes are associated with acceptability. DESIGN Survey. SETTING Children's Hospital Colorado Adolescent Family Planning Clinic in Aurora, Colorado. PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES Young persons 14-24 years of age presenting for any type of visit between March and August 2018. RESULTS A total of 332 participants were enrolled; the majority (62.3%) had high LARC acceptability. We found 5 "attitude" factors: 77.7% of the sample endorsed "Effective" attitudes (eg, wants most effective method), 37.3% endorsed "Good attributes" (eg, discreet, convenient), 23.1% endorsed "Scary" (eg, fears device will move), 16.1% endorsed "Bad for health," (eg, too many side effects), and 9% endorsed "Not for me" (eg, concerns about pain). Although participants who endorsed "Effective" (OR 6.60, 95% CI 3.01-14.49) and "Good attributes" (OR 3.17, 95% CI 1.51-6.66) were more likely to have high LARC acceptability than those who endorsed "Scary" (OR 0.28, 95% CI: (0.13-0.61)) and "Not for me" (OR 0.07, 95% CI 0.01-0.41) factors, approximately 10% of participants with high LARC acceptability endorsed "Scary" or "Bad for health" attitudes, whereas 54% of those with low LARC acceptability endorsed "Effective" attitudes. CONCLUSION Although most participants had high LARC acceptability and valued contraceptive effectiveness, the association between LARC attitudes and acceptability is nuanced. Providers should identify and discuss young people's contraceptive knowledge, attitudes, and acceptability.
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Best Practices for Counseling Adolescents about the Etonogestrel Implant. J Pediatr Adolesc Gynecol 2020; 33:448-454. [PMID: 32621879 DOI: 10.1016/j.jpag.2020.06.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/22/2020] [Accepted: 06/26/2020] [Indexed: 01/11/2023]
Abstract
Among young persons, ease of use, high efficacy, and high acceptability makes the etonogestrel contraceptive implant an important choice for this age group. Adolescent-friendly, patient-centered counseling considers the patient's cognitive development, the influence of friends and family, as well as their own preferences and values. Age-appropriate language, graphics, and models are useful to explain contraceptive options and relevant side effects. Effectiveness, reversibility, safety, noncontraceptive benefits, and side effects are important attributes and should be discussed when teens are choosing a contraceptive method. In this review we describe suggested best practices for counseling adolescents about the etonogestrel implant so they can make informed, prudent decisions about using this contraceptive method.
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Vieira CS, Fraser IS, Plagianos MG, Burke AE, Westhoff CL, Jensen J, Brache V, Bahamondes L, Merkatz R, Sitruk-Ware R, Blithe DL. Bleeding profile associated with 1-year use of the segesterone acetate/ethinyl estradiol contraceptive vaginal system: pooled analysis from Phase 3 trials. Contraception 2019; 100:438-444. [PMID: 31398307 PMCID: PMC6893119 DOI: 10.1016/j.contraception.2019.07.145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 07/26/2019] [Accepted: 07/30/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To describe bleeding patterns among users of the segesterone acetate (SA) and ethinyl estradiol (EE) contraceptive vaginal system (CVS), and identify factors associated with unscheduled bleeding/spotting (B/S). STUDY DESIGN We pooled results from two multicenter, single-arm, open-label, pivotal, phase 3 studies of the SA/EE CVS conducted in 17 US and 7 international sites. Participants (age 18-40 years; BMI ≤29 kg/m2) followed a 21/7-day in/out schedule of CVS use for up to 13 cycles and recorded vaginal bleeding daily in paper diaries. Scheduled and unscheduled B/S were summarized by cycle. We used multiple logistic regression to identify factors associated with unscheduled bleeding/spotting, based on the first 4 cycles only. RESULTS Analysis included data from 2070 participants (16,408 cycles). Ninety-eight percent documented scheduled B/S [mean (SD): 4.9 (1.1) days/cycle)]. Absence of scheduled B/S was 5-8% of women/cycle. Unscheduled B/S ranged from 13.2% to 21.7% of women per cycle. Few women (1.8%) discontinued prematurely due to unacceptable bleeding. Black women were more likely to report unscheduled B/S than White women [Adjusted odds ratio (AOR) = 1.49, 95% confidence interval (CI) = 1.14-1.94]. Women with fewer years of schooling [ CONCLUSIONS Participants using the SA/EE CVS up to 13 cycles reported good cycle control. Discontinuation due to unacceptable bleeding was very low. Further research into demographic/other differences with reported unscheduled bleeding is warranted. IMPLICATIONS Since good cycle control is a key factor influencing contraceptive selection, adherence and continuation of combined hormonal contraceptives, the favorable bleeding profiles experienced by women during the SA/EE CVS clinical trials provide reassuring information for prospective users.
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Affiliation(s)
- Carolina Sales Vieira
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900 - Campus Universitário - Monte Alegre, CEP: 14049-900, Ribeirão Preto, SP, Brazil.; Population Council, 1230 York Avenue, New York City, NY, 10065, USA..
| | - Ian S Fraser
- The University of New South Wales, School of Women's and Children's Health, Royal Hospital for Women, Barker Street, Randwick, NSW 2031, Australia
| | | | - Anne E Burke
- Department of Gynecology and Obstetrics, the Johns Hopkins University School of Medicine, Bayview Medical Center, Baltimore, MD 21224, USA
| | - Carolyn L Westhoff
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York City, NY 10032, USA
| | - Jeffrey Jensen
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR, 97239, USA
| | | | - Luis Bahamondes
- Department of Obstetrics and Gynecology, Faculty of Medical Science, University of Campinas, Caixa Postal 6181, CEP 13084-971, Campinas, SP, Brazil
| | - Ruth Merkatz
- Population Council, 1230 York Avenue, New York City, NY, 10065, USA
| | | | - Diana L Blithe
- Contraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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Griffin JB, Ridgeway K, Montgomery E, Torjesen K, Clark R, Peterson J, Baggaley R, van der Straten A. Vaginal ring acceptability and related preferences among women in low- and middle-income countries: A systematic review and narrative synthesis. PLoS One 2019; 14:e0224898. [PMID: 31703094 PMCID: PMC6839883 DOI: 10.1371/journal.pone.0224898] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/23/2019] [Indexed: 11/30/2022] Open
Abstract
The vaginal ring (VR) is a female-initiated drug-delivery platform used for different indications, including HIV pre-exposure prophylaxis (PrEP). We conducted a systematic review of VR acceptability, values and preferences among women in low- and middle-income countries (LMIC) to inform further investment and/or guidance on VR use for HIV prevention. Following PRISMA guidelines, we used structured methods to search, screen, and extract data from randomized controlled trials (RCTs) and observational studies reporting quantitative outcomes of acceptability of the VR for any indication published 1/1970-2/2019 (PROSPERO: CRD42019122220). Of 1,110 records identified, 68 met inclusion criteria. Studies included women 15-50+ years from 25 LMIC for indications including HIV prevention, contraception, abnormal bleeding, and menopause. Overall VR acceptability was high (71-98% across RCTs; 62-100% across observational studies), with 80-100% continuation rates in RCTs and favorable ease of insertion (greater than 85%) and removal 89-99%). Users reported concerns about the VR getting lost in the body (8-43%), although actual expulsions and adverse events were generally infrequent. Most women disclosed use to partners, with some worrying about partner anger/violence. The VR was not felt during intercourse by 70-92% of users and 48-97% of partners. Acceptability improved over time both within studies (as women gained VR experience and worries diminished), and over chronological time (as the device was popularized). Women expressed preferences for accessible, long-acting, partner-approved methods that prevent both HIV and pregnancy, can be used without partner knowledge, and have no impact on sex and few side effects. This review was limited by a lack of standardization of acceptability measures and study heterogeneity. This systematic review suggests that most LMIC women users have a positive view of the VR that increases with familiarity of use; and, that many would consider the VR an acceptable future delivery device for HIV prevention or other indications.
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Affiliation(s)
- Jennifer B. Griffin
- RTI International, Center for Global Health, Durham, NC, United States of America
| | - Kathleen Ridgeway
- FHI 360, Global Health Population and Nutrition, Durham, NC, United States of America
| | - Elizabeth Montgomery
- RTI International, Center for Global Health, Durham, NC, United States of America
| | - Kristine Torjesen
- FHI 360, Global Health Population and Nutrition, Durham, NC, United States of America
| | - Rachel Clark
- RTI International, Public Health Research Division, Durham, NC, United States of America
| | - Jill Peterson
- FHI 360, Global Health Population and Nutrition, Durham, NC, United States of America
| | | | - Ariane van der Straten
- RTI International, Center for Global Health, Durham, NC, United States of America
- University of California, San Francisco, Department of Medicine, San Francisco, CA, United States of America
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A Biopsychosocial Model for the Counseling of Hormonal Contraceptives: A Review of the Psychological, Relational, Sexual, and Cultural Elements Involved in the Choice of Contraceptive Method. Sex Med Rev 2019; 7:587-596. [DOI: 10.1016/j.sxmr.2019.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/17/2019] [Accepted: 06/19/2019] [Indexed: 12/22/2022]
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Rodríguez-Rodríguez R, Polentinos-Castro E, Azcoaga-Lorenzo A, González-Fernández C. Uso de la anticoncepción con solo gestágenos en atención primaria: estudio GESTAGAP. Aten Primaria 2019; 51:479-485. [PMID: 30115450 PMCID: PMC6837132 DOI: 10.1016/j.aprim.2018.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/20/2018] [Accepted: 05/22/2018] [Indexed: 11/19/2022] Open
Abstract
Objetivo Estimar la prevalencia de uso de anticoncepción hormonal de solo gestágenos (AHSG) entre las mujeres demandantes de anticoncepción reversible en atención primaria (AP). Diseño Estudio descriptivo transversal multicéntrico. Emplazamiento AP de la Comunidad de Madrid. Participantes Mujeres entre 16-50 años, usuarias de anticoncepción reversible, que hablen español y hubieran acudido en el último año a consulta de AP. Mediciones principales Encuesta telefónica. Variable principal: método anticonceptivo utilizado: solo gestágenos (sí/no). Edad, paridad, país de origen, tipo de método anticonceptivo (MAC) utilizado, motivo de elección, duración, fuente de información, lugar de obtención, satisfacción con el método. Resultados 417 mujeres. Edad: media 30,3 años (DE: 7,7). Españolas: 69%, estudios secundarios y universitarios: 82%, nulíparas: 57%. Tipo de MAC utilizado: AHSG 14%, hormonal combinado (AHC): 74%, DIU cobre: 2%, preservativo: 10%. La prevalencia de uso de AHSG fue del 13,9% (IC 95%: 10,6-17,2). Entre los AHSG el método más utilizado fue el inyectable trimestral de acetato de medroxiprogesterona (4,6%), píldora oral de desogestrel (4,1%), DIU-LNG (3,9%), implante subdérmico de etonogestrel (1,9%). El médico de familia fue el prescriptor del MAC en el 71% de las mujeres. Satisfacción: alta (mediana 10 sobre 10). Utilizar AHSG se asoció con mayor edad, ser extranjera y motivos de prescripción: lactancia y tener contraindicación médica para AHC (p < 0,05). Conclusiones La prevalencia de uso para la AHSG fue del 14%, la satisfacción fue muy alta para todos los MAC. El perfil de usuaria para la AHSG corresponde a mujer de mayor edad, extranjera y con condiciones como la lactancia o la contraindicación para otros MAC.
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Casado-Espada NM, de Alarcón R, de la Iglesia-Larrad JI, Bote-Bonaechea B, Montejo ÁL. Hormonal Contraceptives, Female Sexual Dysfunction, and Managing Strategies: A Review. J Clin Med 2019; 8:E908. [PMID: 31242625 PMCID: PMC6617135 DOI: 10.3390/jcm8060908] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/06/2019] [Accepted: 06/24/2019] [Indexed: 12/18/2022] Open
Abstract
In recent decades, hormonal contraceptives (HC) has made a difference in the control of female fertility, taking an unequivocal role in improving contraceptive efficacy. Some side effects of hormonal treatments have been carefully studied. However, the influence of these drugs on female sexual functioning is not so clear, although variations in the plasma levels of sexual hormones could be associated with sexual dysfunction. Permanent hormonal modifications, during menopause or caused by some endocrine pathologies, could be directly related to sexual dysfunction in some cases but not in all of them. HC use seems to be responsible for a decrease of circulating androgen, estradiol, and progesterone levels, as well as for the inhibition of oxytocin functioning. Hormonal contraceptive use could alter women's pair-bonding behavior, reduce neural response to the expectation of erotic stimuli, and increase sexual jealousy. There are contradictory results from different studies regarding the association between sexual dysfunction and hormonal contraceptives, so it could be firmly said that additional research is needed. When contraceptive-related female sexual dysfunction is suspected, the recommended therapy is the discontinuation of contraceptives with consideration of an alternative method, such as levonorgestrel-releasing intrauterine systems, copper intrauterine contraceptives, etonogestrel implants, the permanent sterilization of either partner (when future fertility is not desired), or a contraceptive ring.
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Affiliation(s)
- Nerea M Casado-Espada
- Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain.
| | - Rubén de Alarcón
- Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain.
| | - Javier I de la Iglesia-Larrad
- Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain.
| | - Berta Bote-Bonaechea
- Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain.
| | - Ángel L Montejo
- Psychiatry Service, Institute of Biomedical Research of Salamanca (IBSAL), University Clinical Hospital of Salamanca, Paseo San Vicente, SN 37007 Salamanca, Spain.
- Nursing School E.U.E.F., University of Salamanca, Av. Donantes de Sangre SN 37007 Salamanca, Spain.
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Ibrahim H, Tengku Ismail TA, Hashim N. Comparison of body weight among hormonal and non-hormonal users in a Malaysian cohort. J Taibah Univ Med Sci 2018; 14:25-30. [PMID: 31435386 PMCID: PMC6694937 DOI: 10.1016/j.jtumed.2018.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/17/2018] [Accepted: 11/19/2018] [Indexed: 11/13/2022] Open
Abstract
Objectives Weight gain remains an issue for contraceptive users due to the high prevalence of obesity. This retrospective study compares the weight gain between hormonal and non-hormonal contraceptive users in government health clinics in Kota Bharu, Kelantan, Malaysia. Methods A total of 380 women who had used the same contraceptive method for at least twelve months were recruited in this study. Covariance analysis was done to compare the weight gain between hormonal and non-hormonal contraceptive users, while studying the same confounders [age, household income, number of pregnancies, and baseline body mass index (BMI)]. Results Hormonal methods were more commonly used. The mean weight gain among hormonal users (adjusted mean 2.85, 95% CI 2.45, 3.24) was significantly higher than non-hormonal users (adjusted mean 0.46, 95% CI -0.73, 1.65; p-value <0.001), after controlling for age, household income, number of pregnancies, and baseline BMI. Conclusion The possibility of weight gain following the use of hormonal methods should be investigated and non-hormonal methods should be considered to prevent weight gain.
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Affiliation(s)
- Hafizah Ibrahim
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
- Corresponding address: Department of Community Medicine, Pusat Pengajian Sains Perubatan, Kampus Kesihatan, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
| | - Tengku Alina Tengku Ismail
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Noran Hashim
- Family Health Development Division, Kelantan State Health Department, Kota Bharu, Kelantan, Malaysia
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15
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Cagnacci A, Bastianelli C, Neri M, Cianci A, Benedetto C, Calanni L, Vignali M, De Leo V, Cicinelli E, Borrelli G, Volpe A. Treatment continuation and satisfaction in women using combined oral contraception with nomegestrol acetate and oestradiol: a multicentre, prospective cohort study (BOLERO). EUR J CONTRACEP REPR 2018; 23:393-399. [DOI: 10.1080/13625187.2018.1541080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Angelo Cagnacci
- Clinica Ginecologica e Ostetrica, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Carlo Bastianelli
- Dipartimento di Scienze Ostetriche e Ginecologiche e Scienze Urologiche, La Sapienza Università di Roma, Rome, Italy
| | - Manuela Neri
- Clinica Ostetrica e Ginecologica, Dipartimento di Scienze Chirurgiche, Università degli Studi di Cagliari, Azienda Ospedaliero Universitaria di Cagliari, Policlinico Universitario Duilio Casula, Monserrato, Italy
| | - Antonio Cianci
- Dipartimento Chirurgia Generale e Specialità Medico Chirurgiche, Azienda Ospedaliero Universitaria Policlinico-Vittorio Emanuele, Catania, Italy
| | - Chiara Benedetto
- Dipartimeto di Scienze Chirurgiche, Università degli Studi di Torino, Turin, Italy
| | - Luana Calanni
- Clinica Ostetrica e Ginecologia, Ospedale Policlinico San Martino, Genoa, Italy
| | - Michele Vignali
- Dipartimento di Scienze Biomedicine per la Salute, Università degli Studi di Milano, Milan, Italy
| | - Vincenzo De Leo
- Dipartimento di Medicina Molecolare e dello Sviluppo, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Ettore Cicinelli
- 2° Unità Operativa di Ginecologia ed Ostetricia, Dipartimento di Medicina e Oncologia (DIMO), Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | | | - Annibale Volpe
- Facoltà di Medicina e Chirurgia Materno-Infantili e dell’Adulto, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
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16
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Linet T. [The contraception consultation: CNGOF Contraception Guidelines]. ACTA ACUST UNITED AC 2018; 46:792-798. [PMID: 30377091 DOI: 10.1016/j.gofs.2018.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Determine the most accurate information to give to women, the most efficient way of doing it, the physical examination during a contraceptive visit and the most appropriate follow-up. METHODS A systematic review of French-speaking or English-speaking evidence-based literature about contraception and its visit was performed using Pubmed, Cochrane and international recommendations. RESULTS Showing a contraceptive preference decreases women's satisfaction (EL1) and may decrease contraceptive persistence (EL4). A GATHER's like structured consultation is recommended (Grade A). It allows a contraceptive choice improvement (EL2). Contraceptive knowledge improvement associated with a structured consultation allows a decrease in unplanned pregnancies (EL1) compared to a traditional non-personalized consultation. The main expectations of women are slightly different from what is expected by practitioners (EL2). The main topics to be addressed are efficiency, risks, cost, duration of action and practicality (EL2). The quality of interpersonal communication could allow greater contraceptive persistence (EL2). A careful behavior at the beginning of the consultation and facilitating the expression of the woman's point of view could increase the persistence of the initially prescribed contraception (EL2). Explaining the chosen contraception's adverse effect is recommended because it could allow a better persistence (Grade B). Decision aids has shown interest in the therapeutic choice (EL1). Computerized modules or slide shows in the waiting room before consultation could make the contraceptive choice easier (EL2). The presentation of contraception by effectiveness categories is better than pregnancy numbers for comparing the methods (EL1). Performing a blood pressure measurement prior to an estroprogestative contraception prescription is recommended (Grade C). In women without risk factors, literature data do not allow specific recommendations regarding breast, pelvic examination, laboratory screening and follow-up (Professional agreement).
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Affiliation(s)
- T Linet
- Service de gynécologie-obstétrique, centre hospitalier Loire Vendée Océan, boulevard Guérin, 85300 Challans, France.
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17
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Mburu G, Ndimbii J, Ayon S, Mlewa O, Mbizvo M, Kihara C, Ragi A. Contraceptive Use Among Women Who Inject Drugs: Motivators, Barriers, and Unmet Needs. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/23293691.2018.1463737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Gitau Mburu
- Division of Health Research, University of Lancaster, United Kingdom
| | | | | | | | | | - Cecilia Kihara
- International HIV/AIDS Alliance, Brighton, United Kingdom
| | - Allan Ragi
- Kenya AIDS NGO Consortium, Nairobi, Kenya
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18
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Bardaweel SK, Akour AA, ALkhawaldeh A. Impediments to use of oral contraceptives among refugee women in camps, Jordan. Women Health 2018; 59:252-265. [PMID: 30040539 DOI: 10.1080/03630242.2018.1452837] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study aimed to assess factors related to oral contraceptive (OC) use among refugee married women in the age range 18-50 years, residing in refugee camps in Jordan. METHODS A face-to-face questionnaire was completed by 425 women, who had used OCs at least once in their lifetime as a contraceptive method. Data were collected between November 2016 and January 2017. RESULTS About 45 percent of women preferred OCs as a contraceptive method. Most (80 percent) women thought OCs were effective, while 68.5 percent were concerned about their safety. About 10.6 percent women became pregnant while using OCs, and 75 percent reported side effects, specifically headache (54.6 percent), irritability (46.4 percent), mood swings (39.1 percent), and weight gain (30.6 percent). However, only 21.2 percent of participating women reported that they knew how to use OCs. Alarmingly, 85.9 percent of women reported that they skipped the OC pill when they missed using it. Knowledge about correct use was directly correlated with education, number of pregnancies and children, and duration of OC use. CONCLUSION Women residing in refugees' camps in Jordan had relative unwillingness to use OCs. Although they tended to use them appropriately and had fair experience with their use, large gaps in their knowledge were apparent.
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Affiliation(s)
- Sanaa K Bardaweel
- a Department of Pharmaceutical Sciences, Faculty of Pharmacy , The University of Jordan , Amman , Jordan
| | - Amal A Akour
- b Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy , The University of Jordan , Amman , Jordan
| | - Aseel ALkhawaldeh
- a Department of Pharmaceutical Sciences, Faculty of Pharmacy , The University of Jordan , Amman , Jordan
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19
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Polis CB, Hussain R, Berry A. There might be blood: a scoping review on women's responses to contraceptive-induced menstrual bleeding changes. Reprod Health 2018; 15:114. [PMID: 29940996 PMCID: PMC6020216 DOI: 10.1186/s12978-018-0561-0] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 06/15/2018] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Concern about side effects and health issues are common reasons for contraceptive non-use or discontinuation. Contraceptive-induced menstrual bleeding changes (CIMBCs) are linked to these concerns. Research on women's responses to CIMBCs has not been mapped or summarized in a systematic scoping review. METHODS We conducted a systematic scoping review of data on women's responses to CIMBCs in peer-reviewed, English-language publications in the last 15 years. Investigator dyads abstracted information from relevant studies on pre-specified and emergent themes using a standardized form. We held an expert consultation to obtain critical input. We provide recommendations for researchers, contraceptive counselors, and product developers. RESULTS We identified 100 relevant studies. All world regions were represented (except Antarctica), including Africa (11%), the Americas (32%), Asia (7%), Europe (20%), and Oceania (6%). We summarize findings pertinent to five thematic areas: women's responses to contraceptive-induced non-standard bleeding patterns; CIMBCs influence on non-use, dissatisfaction or discontinuation; conceptual linkages between CIMBCs and health; women's responses to menstrual suppression; and other emergent themes. Women's preferences for non-monthly bleeding patterns ranged widely, though amenorrhea appears most acceptable in the Americas and Europe. Multiple studies reported CIMBCs as top reasons for contraceptive dissatisfaction and discontinuation; others suggested disruption of regular bleeding patterns was associated with non-use. CIMBCs in some contexts were perceived as linked with a wide range of health concerns; e.g., some women perceived amenorrhea to cause a buildup of "dirty" or "blocked" blood, in turn perceived as causing blood clots, fibroids, emotional disturbances, weight gain, infertility, or death. Multiple studies addressed how CIMBCs (or menstruation) impacted daily activities, including participation in domestic, work, school, sports, or religious life; sexual or emotional relationships; and other domains. CONCLUSIONS Substantial variability exists around how women respond to CIMBCs; these responses are shaped by individual and social influences. Despite variation in responses across contexts and sub-populations, CIMBCs can impact multiple aspects of women's lives. Women's responses to CIMBCs should be recognized as a key issue in contraceptive research, counseling, and product development, but may be underappreciated, despite likely - and potentially substantial - impacts on contraceptive discontinuation and unmet need for modern contraception.
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Affiliation(s)
- Chelsea B. Polis
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038 USA
| | - Rubina Hussain
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038 USA
| | - Amanda Berry
- Guttmacher Institute, 125 Maiden Lane, 7th Floor, New York, NY 10038 USA
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20
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Merki-Feld GS, Caetano C, Porz TC, Bitzer J. Are there unmet needs in contraceptive counselling and choice? Findings of the European TANCO Study. EUR J CONTRACEP REPR 2018; 23:183-193. [DOI: 10.1080/13625187.2018.1465546] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- G. S. Merki-Feld
- Department of Reproductive Endocrinology, University Hospital, Zurich, Switzerland
| | | | | | - J. Bitzer
- Department of Obstetrics/Gynecology, University Hospital, Basel, Switzerland
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21
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Bitzer J, Marin V, Lira J. Contraceptive counselling and care: a personalized interactive approach. EUR J CONTRACEP REPR 2018; 22:418-423. [DOI: 10.1080/13625187.2017.1414793] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Johannes Bitzer
- Department of Obstetrics and Gynaecology, University Hospital, Basel, Switzerland
| | | | - Josefina Lira
- Department of Adolescent Gynecology, Instituto Nacional de Perinatologia, Universidad Nacional Autónoma de México, Mexico City, Mexico
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22
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Nappi RE, Lobo Abascal P, Hsieh J, Micheletti MC. Cycle control with an extended-regimen oral contraceptive combining levonorgestrel and ethinyl estradiol that includes continuous low-dose ethinyl estradiol instead of the traditional hormone-free interval. Int J Womens Health 2017; 9:739-747. [PMID: 29042818 PMCID: PMC5633331 DOI: 10.2147/ijwh.s142078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate scheduled and unscheduled bleeding and spotting over 1 year of treatment with 91-day extended-regimen combined oral contraception (COC) providing continuous low-dose ethinyl estradiol (EE) in place of the traditional 7-day hormone-free interval (HFI). PATIENTS AND METHODS This post hoc analysis of a multicenter, open-label, 1-year, Phase 3 study of extended-regimen COC with 30 µg EE/150 µg levonorgestrel (LNG) for 84 days and EE 10 µg for 7 days included 799 sexually active, adult women who completed at least one 91-day cycle of therapy. Subjects recorded bleeding and spotting episodes daily using electronic diaries. Logistic regression analyses are reported as ORs with 95% CIs. RESULTS There was a 10% increase (OR =1.102; 95% CI: 1.006-1.206) in the likelihood of reporting no scheduled bleeding for each additional 91-day cycle completed. From the third 91-day cycle, more than one fifth of women reported no scheduled bleeding (third cycle =23% [121/533]; fourth cycle =22% [97/446]). Among women who reported no scheduled bleeding at Cycle 1 (136/758 [18%]), ≥45% showed sustained lack of scheduled bleeding in later cycles. There were increases of 53% (OR =1.531; 95% CI: 1.393-1.683) and 31% (OR =1.307; 95% CI: 1.205-1.418) in the likelihood of reporting 0 to ≤6 days vs >6 days of unscheduled bleeding and spotting, respectively, for each additional 91-day cycle. By Cycle 2, more than 80% of women reported no unscheduled bleeding or ≤6 days of unscheduled bleeding during each 91-day cycle. CONCLUSION Improved cycle control with decreased bleeding over time was shown during extended-regimen COC with 30 µg EE/150 µg LNG for 84 days and continuous low-dose EE instead of the traditional 7-day HFI. Women considering this regimen should be informed that those who complete at least one 91-day COC cycle will likely experience less bleeding/spotting in future cycles.
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Affiliation(s)
- Rossella E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Paloma Lobo Abascal
- Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Jennifer Hsieh
- Teva Branded Pharmaceutical Products R&D, Inc., Malvern, PA, USA
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Jamin CG, Häusler G, Lobo Abascal P, Fiala C, Lete Lasa LI, Nappi RE, Micheletti MC, Fernández-Dorado A, Pintiaux A, Chabbert-Buffet N. Development and conceptual validation of a questionnaire to help contraceptive choice: CHLOE (Contraception: HeLping for wOmen's choicE). EUR J CONTRACEP REPR 2017; 22:286-290. [PMID: 28877640 DOI: 10.1080/13625187.2017.1364719] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this research was to develop a questionnaire to facilitate choice of the most appropriate contraceptive method for individual women. METHODS A literature review was conducted to identify key aspects influencing contraceptive choice and inform development of a questionnaire for online completion. Questionnaire development was overseen by a steering committee consisting of eight gynaecologists from across Europe. The initial draft underwent conceptual validation through cognitive debriefing interviews with six native English-speaking women. A qualitative content analysis was conducted to accurately identify potential issues and areas for questionnaire improvement. A revised version of the questionnaire then underwent face-to-face and online evaluation by 115 international gynaecologists/obstetricians with expertise in contraception, prior to development of a final version. RESULTS The final conceptually validated Contraception: HeLping for wOmen's choicE (CHLOE) questionnaire takes ≤10 min to complete and includes three sections to elicit general information about the individual, the health conditions that might influence contraceptive choice, and the woman's needs and preferences that might influence contraceptive choice. The questionnaire captures the core aspects of personalisation, efficacy and safety, identified as key attributes influencing contraceptive choice, and consists of 24 closed-ended questions for online completion prior to a health care provider (HCP) consultation. The HCP receives a summary of the responses. CONCLUSION The CHLOE questionnaire has been developed to help women choose the contraception that best suits their needs and situation while optimising the HCP's time.
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Affiliation(s)
| | - Gunther Häusler
- b Department of Gynaecology and Gynaecological Oncology , Vienna General Hospital , Vienna , Austria
| | - Paloma Lobo Abascal
- c Department of Obstetrics and Gynaecology , Infanta Sofía University Hospital , Madrid , Spain
| | - Christian Fiala
- d Gynmed Ambulatorium , Vienna , Austria.,e Department of Women's and Children's Health , Karolinska Institute , Stockholm , Sweden
| | - Luis Ignacio Lete Lasa
- f Department of Obstetrics and Gynaecology , Araba University Hospital , Vitoria-Gasteiz , Spain
| | - Rossella Elena Nappi
- g Research Centre for Reproductive Medicine, Gynaecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences , University of Pavia , Pavia , Italy
| | | | | | - Axelle Pintiaux
- j Department of Obstetrics and Gynaecology , Erasmus Hospital, Free University of Brussels , Brussels , Belgium
| | - Natalie Chabbert-Buffet
- k Department of Obstetrics and Gynaecology , APHP Tenon Hospital, Pierre and Marie Curie University , Paris , France
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24
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Loewenberg Weisband Y, Keder LM, Keim SA, Gallo MF. Postpartum intentions on contraception use and method choice among breastfeeding women attending a university hospital in Ohio: a cross-sectional study. Reprod Health 2017; 14:45. [PMID: 28320478 PMCID: PMC5360022 DOI: 10.1186/s12978-017-0307-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 03/13/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Few postpartum women use effective contraception and those who use less effective methods have increased rates of unintended pregnancy. Little is known about postpartum contraception intentions among breastfeeding women. Our objectives were to measure the extent of prenatal contraceptive counseling, to assess contraceptive intentions, and to identify correlates of both among postpartum women who were planning to breastfeed. METHODS We conducted a cross-sectional study using a convenience sample of 100 breastfeeding women before their discharge following delivery at a large university hospital in 2015. We used logistic regression to assess three outcomes of interest: not intending to use contraception before 6 months postpartum, reporting receiving counseling on postpartum contraception during prenatal care, and considering the effects of contraception methods on the breastfeeding mother-infant dyad when choosing a postpartum contraception method. RESULTS Most women (91%) intended to use contraception. Prior history of no contraception use was the sole factor related to not intending to use contraception. The most commonly cited reason for the intended choice of contraceptive method was convenience (35%). Few women (21%) reported considering the effects of contraception methods on the breastfeeding dyad when choosing a postpartum contraception method. Nearly half of women reported never discussing postpartum contraception options with their healthcare provider during prenatal care. In the multivariate analysis, receiving public assistance was the only factor that remained statistically significantly associated with reporting having received contraception counseling during prenatal care. CONCLUSIONS Although most women intended to use contraception, they did not appear to have received adequate prenatal counseling on postpartum contraception.
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Affiliation(s)
| | - Lisa M. Keder
- The Department of Obstetrics and Gynecology, Ohio State University, Columbus, OH 43210 USA
| | - Sarah A. Keim
- Center for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205 USA
| | - Maria F. Gallo
- The Ohio State University, College of Public Health, 1841 Neil Ave, Columbus, OH 43210-1351 USA
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25
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Paul J, Boraas CM, Duvet M, Chang JC. YouTube and the single-rod contraceptive implant: a content analysis. ACTA ACUST UNITED AC 2017; 43:195-200. [PMID: 28108504 DOI: 10.1136/jfprhc-2016-101593] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/18/2016] [Accepted: 12/21/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Since the internet has become an important source of contraceptive information with YouTube.com as the second most visited site, we analysed contraceptive implant YouTube videos for content and clinical accuracy. METHODS Using the terms 'contraceptive implant', 'Nexplanon' and 'Implanon', the top 20 results on YouTube by relevance and view count were identified. After excluding duplicates, single-rod implant videos in English were included. Videos were classified as providing a professional or patient perspective. Views, duration and comments were noted. Videos were rated for reliability, global quality scale and whether they were positive or negative about the implant. Inter-rater agreement was measured. RESULTS A total of 120 videos were retrieved; 52 were eligible for review. Less than 23% were professional videos; the majority reported patient experience (46% testimonials, 27% real-time procedure videos, 4% other). Patient videos had been posted a significantly longer duration of time than professional videos (364 vs 188 days, p=0.02), were less reliable (p≤0.0001) and were of lower global quality (p<0.0001). Some 61% of implant testimonial videos were rated as 'positive experiences' and inter-rater agreement was very good (κ=0.81). All testimonials mentioned side effects, commonly irregular bleeding and discomfort with insertion. A minority (26%) reported misinformation. CONCLUSIONS This study found that most of the information on YouTube pertaining to contraceptive implants is accurate, is presented from the patient's perspective, and promotes the method's use.
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Affiliation(s)
- Jennifer Paul
- Kaiser Permanente, Greater Baltimore Medical Center, 7141 Security Boulevard, Baltimore, MD, USA.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Christy M Boraas
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Obstetrics, Gynecology and Women's Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Mildred Duvet
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Obstetrics and Gynecology, Leigh Valley Health Network, Allentown, PA, USA
| | - Judy C Chang
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Magee-Womens Research Institute, Pittsburgh, PA, USA.,Center for Research in Health Care/Center for Women's Health Research and Innovation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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26
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He K, Dalton VK, Zochowski MK, Hall KS. Women's Contraceptive Preference-Use Mismatch. J Womens Health (Larchmt) 2016; 26:692-701. [PMID: 27710196 DOI: 10.1089/jwh.2016.5807] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Family planning research has not adequately addressed women's preferences for different contraceptive methods and whether women's contraceptive experiences match their preferences. METHODS Data were drawn from the Women's Healthcare Experiences and Preferences Study, an Internet survey of 1,078 women aged 18-55 randomly sampled from a national probability panel. Survey items assessed women's preferences for contraceptive methods, match between methods preferred and used, and perceived reasons for mismatch. We estimated predictors of contraceptive preference with multinomial logistic regression models. RESULTS Among women at risk for pregnancy who responded with their preferred method (n = 363), hormonal methods (non-LARC [long-acting reversible contraception]) were the most preferred method (34%), followed by no method (23%) and LARC (18%). Sociodemographic differences in contraception method preferences were noted (p-values <0.05), generally with minority, married, and older women having higher rates of preferring less effective methods, compared to their counterparts. Thirty-six percent of women reported preference-use mismatch, with the majority preferring more effective methods than those they were using. Rates of match between preferred and usual methods were highest for LARC (76%), hormonal (non-LARC) (65%), and no method (65%). The most common reasons for mismatch were cost/insurance (41%), lack of perceived/actual need (34%), and method-specific preference concerns (19%). CONCLUSION While preference for effective contraception was common among this sample of women, we found substantial mismatch between preferred and usual methods, notably among women of lower socioeconomic status and women using less effective methods. Findings may have implications for patient-centered contraceptive interventions.
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Affiliation(s)
- Katherine He
- 1 University of Michigan Medical School , Ann Arbor, Michigan
| | - Vanessa K Dalton
- 2 Department of Obstetrics and Gynecology, Program on Women's Health Care Effectiveness Research, Institute for Healthcare Policy and Innovation, University of Michigan , Ann Arbor, Michigan
| | - Melissa K Zochowski
- 3 Undergraduate Research Opportunity Program, University of Michigan , Ann Arbor, Michigan
| | - Kelli Stidham Hall
- 4 Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University , Atlanta, Georgia
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Kumar S, Nabh D, Arora R, Garg P. Impact of Structured Counseling with Trained Counselors in Choosing a Modern Contraceptive Method in India. J Obstet Gynaecol India 2016; 66:548-59. [PMID: 27651660 DOI: 10.1007/s13224-016-0887-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/19/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The study was designed to determine the impact of structured counseling by trained contraceptive counselors in a real-life clinical setting on the adoption of modern contraceptive methods in comparison with past contraceptive experience. METHODS Current study was a retrospective, non-interventional design, from the data collected in the time period of March to September 2013 across four clinics with predominant obstetric and gynecological practice. Three hundred and fifty-one women consulting for contraception were counseled by trained counselors using standardized counseling tools. RESULTS Of the 351 women counseled, 40.74 % (n = 143) had never used a contraceptive (no method) and 42.74 % (n = 150) women whose partner had or were using a "male condom." Post-counseling by a trained counselor, there was a significant (p < 0.001) increase in modern contraceptive use (91.74 %, n = 322) versus prior counseling (52.14 %, n = 183) proportion of women who had or were using a modern contraceptive. The change observed for each method pre-counseling (usage history) to post-counseling was as follows: combined oral contraceptive (COC) 1.99-5.41 %, progesterone-only pill (POP) 0.85-30.48 %; copper intrauterine device (Cu-IUD) 4.27-29.4 %; injectable contraceptive 1.71-20.51 %; male condom 42.74-1.42 %; no method 40.74-7.41 %; traditional 7.12-0.85 %; and sterilization 0.28-1.71 %. CONCLUSION This study is a first of its kind, conducted in the private sector, and clearly highlights the benefits of a trained counselor in contraceptive counseling with a significant proportion of women choosing a modern contraceptive. With a busy private practice, a trained counselor facilitates the clinician's role and helped the women to choose a suitable modern contraceptive method.
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Affiliation(s)
- Shakuntla Kumar
- Gynecology and Obstetrics, Nulife Hospitals, 1616, Outram Lines, GTB Nagar, Kingsway Camp, New Delhi, 110009 India
| | - Dipti Nabh
- Department of Gynecology and Obstetrics, Mother and Child Hospital, # 20, Old Anarkali, Krishna Nagar, Landmark: lm-Jain Mandir, New Delhi, India
| | - Rupam Arora
- Department of Gynecology and Obstetrics, Dr. Rupam Arora Clinic, House No. 78, Mausam Vihar, Krishna Nagar, New Delhi, India
| | - Praveen Garg
- Department of Gynecology and Obstetrics, Hitaishi Hospital, E-15/154, Pradeep Bhatia Marg, Sector 8E, Rohini, New Delhi, 110085 India
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Lauring JR, Lehman EB, Deimling TA, Legro RS, Chuang CH. Combined hormonal contraception use in reproductive-age women with contraindications to estrogen use. Am J Obstet Gynecol 2016; 215:330.e1-7. [PMID: 27059507 DOI: 10.1016/j.ajog.2016.03.047] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 03/25/2016] [Accepted: 03/28/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Centers for Disease Control and Prevention's US Medical Eligibility Criteria for Contraceptive Use recommends that combined hormonal contraceptives (ie, birth control pills, contraceptive patch, vaginal ring) should be avoided in women with specific medical conditions because of the increased risk of cardiovascular events associated with estrogen use. Whether women with category 3 (theoretical or proven risk usually outweigh the advantages) or category 4 (unacceptable health risk) contraindications are appropriately avoiding estrogen-containing combined hormonal contraceptives is unknown. OBJECTIVE We describe the prevalence of combined hormonal contraceptive use among a sample of reproductive-age women with medical contraindications to estrogen use. Our hypothesis was that women with categories 3 and 4 contraindications would use estrogen-containing contraception less often than women without medical contraindications. We also explored whether inappropriate estrogen-containing contraceptive use is related to contraceptive provider characteristics. STUDY DESIGN Data are from the baseline survey of the MyNewOptions study, which included privately insured women residing in Pennsylvania aged 18-40 years, who were sexually active and not intending pregnancy in the next year. Women were surveyed about their medical conditions, contraceptive use, and characteristics of their contraceptive provider. Women were considered to have a contraindication to combined hormonal contraceptives if they reported a category 3 or category 4 contraindication: hypertension, smokers older than age 35 years, a history of venous thromboembolism, diabetes with complications, coronary artery disease, systemic lupus erythematosus with antiphospholipid antibodies, breast cancer, or migraine headaches with aura. χ(2) tests for general association were used to compare combined hormonal contraceptives use, contraceptive health provider characteristics, and sociodemographic data in women with and without contraindications to estrogen use. RESULTS The MyNewOptions baseline study sample included 987 adult women who were mostly young (46% were 18-25 years), white (94%), employed (70%), and married or cohabiting (54%). Thirteen percent (n = 130) of the sample had a medical contraindication to estrogen-containing contraceptive use: migraine with aura (81%) was the most common contraindication, followed by smokers older than age 35 years (7%), hypertension (11%), history of venous thromboembolism (4%), and diabetes with complications (2%). High use of combined hormonal contraceptives was reported among the women with medical contraindications to estrogen at 39% (n = 51). This was not statistically different from women without a medical contraindication (47%, P = .1). Among the 130 women with a contraindication, whether they did or did not use an estrogen-containing contraceptive did not vary by education level, income, or weight category. With respect to their contraceptive prescribers, there were no differences in prescriber specialty, provider type, or clinic type comparing women using and not using an estrogen-containing contraceptive. CONCLUSION Among this study sample of reproductive-age women, there was a high rate of combined hormonal contraceptive use in women with a medical contraindication to estrogen use. These women may be at an increased risk for cardiovascular events. Processes need to be improved to ensure that women with medical contraindications to estrogen-containing contraception are being offered the safest and most effective methods, including long-acting reversible contraceptives, such as intrauterine devices and the contraceptive implant.
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Affiliation(s)
- Julianne R Lauring
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Penn State Milton S. Hershey Medical Center, Hershey, PA.
| | - Erik B Lehman
- Department of Public Health Sciences, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - Timothy A Deimling
- Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - Richard S Legro
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - Cynthia H Chuang
- Division of General Internal Medicine, Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA
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Gambera A, Corda F, Papa R, Bastianelli C, Bucciantini S, Dessole S, Scagliola P, Bernardini N, de Feo D, Beligotti F. Observational, prospective, multicentre study to evaluate the effects of counselling on the choice of combined hormonal contraceptives in Italy--the ECOS (Educational COunselling effectS) study. BMC WOMENS HEALTH 2015; 15:69. [PMID: 26329464 PMCID: PMC4557636 DOI: 10.1186/s12905-015-0226-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 08/17/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adequate counselling on contraceptive methods can help users choose the most appropriate method. The aim of this study was to assess the effects of structured counselling provided by gynaecologists on selection of a combined hormonal contraception method. METHODS Women aged 18-40 years (n = 1871) who were considering the use of a combined hormonal contraception method (pill, transdermal patch or vaginal ring) underwent a structured counselling session in which gynaecologists provided comprehensive information. Pre- and post-counselling questionnaires on combined hormonal contraception choice were completed by participants. RESULTS After counselling, many women (38 %) selected a combined hormonal contraception method that was different from the originally intended one. Preferences for the transdermal patch approximately doubled (from 3.2 % pre-counselling to 7 %; p < 0.0001) and those for the vaginal ring increased four-fold (from 5.2 to 21.2 %; p < 0.0001), while preference for the pill remained unchanged (from 64.5 % [pre-] to 64.1 % [post-counselling]). The proportion of undecided women decreased from 18 to 2.1 % (p < 0.0001). The main reasons for choosing a method were related to ease of use (all methods), and preferences for administration frequency (daily, weekly or monthly). The number of patients requiring post-counselling contact with the physician's office was low (5.1-6.9 %), as was the incidence of adverse events (1.8-3.1 %). CONCLUSIONS Counselling has a significant impact on women's choice of combined hormonal contraception and encourages them to consider alternative methods to combined oral contraceptives. Moreover, it also enables women to use their chosen method with confidence. TRIAL REGISTRATION NCT01181778 , Trial registration date: August 12, 2010.
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Affiliation(s)
| | - Fedela Corda
- Centro Donna c/o Ospedale Binaghi, Cagliari, Italy.
| | - Rosetta Papa
- UOC Tutela Salute Donna- ASL Napoli 1 CENTRO, Naples, Italy.
| | - Carlo Bastianelli
- Policlinico Umberto I, Dipartimento di Ginecologia e Ostetricia, Rome, Italy.
| | - Sandra Bucciantini
- Azienda Universitaria Careggi, Divisione Clinica Ostetrica, Florence, Italy.
| | - Salvatore Dessole
- A.O.U. di Sassari Macrostruttura Materno Infantile Clinica Ostetrico Ginecologica, Sassari, Italy.
| | | | - Nadia Bernardini
- MSD Italia S.r.L., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA.
| | - Daniela de Feo
- MSD Italia S.r.L., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA.
| | - Fabiola Beligotti
- MSD Italia S.r.L., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA.
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Birgisson NE, Zhao Q, Secura GM, Madden T, Peipert JF. Preventing Unintended Pregnancy: The Contraceptive CHOICE Project in Review. J Womens Health (Larchmt) 2015. [PMID: 25825986 PMCID: PMC4441000 DOI: 10.1080/13625187.2017.1414793 10.1089/jwh.2015.5191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The Contraceptive CHOICE Project (CHOICE) sought to reduce unintended pregnancies in the St. Louis Region by removing cost, education, and access barriers to highly effective contraception. CHOICE was a prospective cohort study of over 9,000 women 14-45 years of age who received tiered contraceptive counseling to increase awareness of all reversible methods available, particularly long-acting reversible contraceptive (LARC) methods. Participants were provided with contraception of their choice at no cost for 2-3 years. We studied contraceptive method choice, continuation, and population outcomes of repeat abortion and teen pregnancy. Seventy-five percent of study participants chose one of the three LARC methods (46% levonorgestrel intrauterine system, 12% copper intrauterine device, and 17% subdermal implant). LARC users reported greater continuation than non-LARC users at 12 months (87% versus 57%) and 24 months (77% versus 41%). In our cohort, LARC methods were 20 times more effective than non-LARC methods. As a result, we observed a reduction in the percent of repeat abortions from 2006 to 2010 in St. Louis compared with Kansas City and nonmetropolitan Missouri and found substantial reductions in teen pregnancy, birth, and abortion (34.0, 19.4, and 9.7 per 1000 teens, respectively) compared with national rates among sexually experienced teens (158.5, 94.0, and 41.5 per 1000, respectively). Improved access to LARC methods can result in fewer unintended pregnancies and abortions and considerable cost savings to the health care system.
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Nelson AL. Transdermal contraception methods: today’s patches and new options on the horizon. Expert Opin Pharmacother 2015; 16:863-73. [DOI: 10.1517/14656566.2015.1022531] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Woodsong C, Holt J, Devlin B, Rosenberg Z. Current Status of Multipurpose Prevention Technology (MPT) Development. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2015. [DOI: 10.1007/s13669-014-0107-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Yeshaya A, Ber A, Seidman DS, Oddens BJ. Influence of structured counseling on women's selection of hormonal contraception in Israel: results of the CHOICE study. Int J Womens Health 2014; 6:799-808. [PMID: 25187739 PMCID: PMC4149453 DOI: 10.2147/ijwh.s45397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background The multinational CHOICE (Contraceptive Health Research Of Informed Choice Experience) study evaluated the effects of structured counseling on women’s contraceptive decisions, their reasons for making those decisions, and their perceptions of combined hormonal contraceptive (CHC) methods in eleven countries. The aim of this paper to present data from the 1,802 women participating in Israel’s CHOICE program. Methods Women (aged 17–40 years) who consulted their health care providers about contraception and who would consider a CHC method qualified to participate. After indicating their intended CHC method, the women received counseling about the daily pill, weekly patch, and monthly vaginal ring. After counseling, the women completed a questionnaire about their contraceptive decisions. Results Before counseling, 67%, 6%, and 5% of women (mean age 27 years) intended to use the pill, patch, or ring, respectively. Counseling significantly influenced the women’s CHC choice, with 56%, 12%, and 23% of women selecting the pill, patch, or ring (P<0.0001 for all contraceptive methods versus before counseling). Logistic regression analysis suggested that age significantly increased the probability of switching from the pill to the ring. Conclusion Although the pill was the most popular choice overall, counseling appeared to influence Israeli women’s contraceptive decisions, with significantly more women selecting the patch. More than four times as many women selected the ring after counseling than before counseling.
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Affiliation(s)
- Arie Yeshaya
- Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tikva, Israel
| | - Amos Ber
- Maccabi Health Services, Tel Aviv, Israel
| | - Daniel S Seidman
- Department of Obstetrics and Gynecology, Sacker School of Medicine, Tel Hashomer, Israel
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Donnelly KZ, Foster TC, Thompson R. What matters most? The content and concordance of patients' and providers' information priorities for contraceptive decision making. Contraception 2014; 90:280-7. [PMID: 24863169 DOI: 10.1016/j.contraception.2014.04.012] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 04/17/2014] [Accepted: 04/20/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE(S) The objective of this study was to identify women's and health care providers' information priorities for contraceptive decision making and counseling, respectively. STUDY DESIGN Cross-sectional surveys were administered online to convenience samples of 417 women and 188 contraceptive care providers residing in the United States. Participants were provided with a list of 34 questions related to the features of contraceptive options and rated the importance of each. Participants also ranked the questions in descending order of importance. For both women and providers, we calculated the mean importance rating for each question and the proportion that ranked each question in their three most important questions. RESULTS The average importance ratings given by women and providers were similar for 18 questions, but dissimilar for the remaining 16 questions. The question rated most important for women was "How does it work to prevent pregnancy?" whereas, for providers, "How often does a patient need to remember to use it?" and "How is it used?" were rated equally. The eight questions most frequently selected in the top three by women and/or providers were related to the safety of the method, mechanism of action, mode of use, side effects, typical- and perfect-use effectiveness, frequency of administration and when it begins to prevent pregnancy. CONCLUSION(S) Although we found considerable concordance between women's and provider's information priorities, the presence of some inconsistencies highlights the importance of patient-centered contraceptive counseling and, in particular, shared contraceptive decision making. IMPLICATIONS This study provides insights into the information priorities of women for their contraceptive decision making and health care providers for contraceptive counseling. These insights are critical both to inform the development of decision support tools for implementation in contraceptive care and to guide the delivery of patient-centered care.
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Affiliation(s)
- Kyla Z Donnelly
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| | - Tina C Foster
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA; Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Rachel Thompson
- The Dartmouth Center for Health Care Delivery Science, Dartmouth College, Hanover, NH, USA.
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Evaluation of factors associated with noncompliance in users of combined hormonal contraceptive methods: a cross-sectional study: results from the MIA study. BMC WOMENS HEALTH 2013; 13:38. [PMID: 24138751 PMCID: PMC4015733 DOI: 10.1186/1472-6874-13-38] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 10/09/2013] [Indexed: 11/10/2022]
Abstract
Background Understanding contraception from the perspective of the user may help to improve compliance. The aim of this project was to determine the factors that influence the noncompliance in young women that use combined hormonal contraceptives (pill, patch or vaginal ring). Methods A nationwide cross-sectional multicenter epidemiology study. Physicians [obstetricians/gynecologists]) recorded socio-demographic, clinical and current contraception data of 8,762 women. Women completed a self-administered questionnaire on compliance. After the assessment of self-administrated questionnaire, the physicians reported on their recommendations on the possibility of changing the contraceptive. Results Fifty-two percent of women were noncompliant, mainly because of simple forgetfulness (pill, 74.9%; patch, 47.8%; vaginal ring, 69.1%). The percentage of noncompliant women was lower in vaginal ring users (26.6%) than in patch users (42.4%) or pill users (65.1%) (p < 0.0001). The most common course of action after noncompliance was to take/use the contraceptive as soon as possible. In the multiple logistic regression analysis, the use of the pill increased the probability of noncompliance compared with the patch and the vaginal ring (odds ratio [IC95%]: 2.53 (2.13-3.02) and 4.17 (3.68-4.73, respectively), and using the patch compared with the vaginal ring (1.65 (1.36-1.99)). Others factors associated with noncompliance were: high treatment duration, low degree of information on the contraceptive method, understanding of instructions on the contraceptive method, indifference to becoming pregnant, lack of partner support, not participation in selecting the method, not having a routine for taking treatment and difficulties remembering use the contraceptive method. Switching contraceptive method was proposed by the physicians to 43.2% of women (51.8% of pill users, 58.2% of patch users and 19.4% of vaginal ring users). Conclusions More than 50% of combined hormonal contraceptive users did not comply with the treatment regimen. The percentage of noncompliant women was lower between vaginal ring users. Understanding user’s reasons for noncompliance by the clinician and encouraging a collaborative approach can go a long way to improving compliance.
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