Contraceptive adherence among women Veterans with mental illness and substance use disorder

Callegari, Lisa S.; Zhao, Xinhua; Nelson, Karin M.; Borrero, Sonya

doi:10.1016/j.contraception.2015.01.013

Cited by 39 publications

(30 citation statements)

References 35 publications

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“…Prior studies have also found reduced adherence among women with SUD; in one study, Veteran women with combined mental illness and SUD had fewer months of contraceptive coverage in the first year and reduced odds of continuation at 12 months . Our study observed a trend towards lower adherence that was not statistically significant ( P = 0.068).…”

Section: Discussioncontrasting

confidence: 55%

“…Similarly, the American Congress of Obstetricians and Gynecologists recommends prescription contraceptive counseling for women with SUD, including discussion of long‐acting reversible contraceptive (LARC) methods . However, among US Veteran and adolescent populations, women with SUD are less likely than those without SUD to have and adhere to prescription contraceptives . While Medicaid funds SUD care and unintended pregnancy care in the United States disproportionately, no studies have tracked contraceptive use in an SUD population enrolled in Medicaid or subsidized insurance .…”

Section: Introductionmentioning

confidence: 99%

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Prescription contraception use and adherence by women with substance use disorders

et al. 2017

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Section: Discussioncontrasting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Prescription contraception use and adherence by women with substance use disorders

et al. 2017

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“…45 In another study using administrative data from 9,780 women using hormonal contraceptive methods in Fiscal Year 2013, women Veterans with a history of mental illness with or without coexisting substance abuse had similar occurrence of gaps in contraceptive coverage, but gaps were significantly longer compared with women without mental illness. 46 As a result, women with mental illness (with or without SUD) had significantly fewer months of contraceptive coverage compared with those without any diagnoses (7.7 and 8.2 vs. 8.5 months, respectively; p < 0.001).These studies suggest that there are opportunities to enhance contraceptive adherence and continuation with the VA.…”

Section: Contraceptive Adherencementioning

confidence: 82%

Contraceptive Care in the Veterans Health Administration

et al. 2019

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In recent years, the number of women Veterans obtaining care in the Veterans Affairs (VA) Healthcare System has grown, expanding the need for provision of contraceptive care. Women Veterans are a diverse group of women with complex sociodemographic and medical backgrounds, and meeting their needs presents a unique challenge for VA. Efforts including the establishment of comprehensive women's health clinics and training practitioners in women's health have greatly improved healthcare services for women Veterans over the last few decades. Recent data from a large cross-sectional survey study suggest that contraceptive use in VA is similar to the general population and that rates of unintended pregnancy, while still significant, are not higher than that in the general population. Subgroup analyses of this survey data, however, suggest that ongoing efforts are needed to improve outcomes in vulnerable subpopulations of women Veterans, particularly ethnic/racial minorities and Veterans with complex medical backgrounds. Policy changes such as the elimination of copayments for contraceptive prescriptions and the dispensing of more months of contraceptive supply are evidence-based starting points for improvements, in addition to leveraging VA's integrated system and research infrastructure to improve patient-centered counseling and contraceptive access.

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“…Women veterans with mental illness and substance abuse diagnoses in particular have lower adherence to contraceptive methods requiring compliance (eg, pills, patch, ring, and injectable contraception) than women without these diagnoses. 22 Incorporating counseling for long-acting reversible contraception is critical for prevention of unintended pregnancies in all women of reproductive age, especially those with comorbidities that can affect health during and after pregnancy.…”

Section: Common Reproductive Health Conditions and Needs In Women Vetmentioning

confidence: 99%

Reproductive Health Management for the Care of Women Veterans

Zephyrin

2016

Obstetrics & Gynecology

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There are more than 2 million women veterans living in the United States. Many women do not identify themselves as veterans. As women's health care providers, it is important to understand and recognize the potentially complex health and social needs of women veterans and the role of military service on their lives. The reproductive health needs of women veterans may be shaped by their military experiences and coexisting medical or mental health conditions. Military sexual trauma and combat exposure are common causes of posttraumatic stress disorder and can affect overall health and well-being. Screening for military service is important in all women, and inclusion of this as a key demographic variable in research and clinical encounters can further inform health care considerations. The following key topics are addressed: who are women veterans, health and social risk factors associated with a history of military service, reproductive health across the life course, military sexual trauma and reproductive health of women veterans, how to take a military history, and the essential role of women's health providers, including obstetrician-gynecologists, in enhancing health systems and providing high-quality care to veterans.

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Contraceptive adherence among women Veterans with mental illness and substance use disorder

Cited by 39 publications

References 35 publications

Prescription contraception use and adherence by women with substance use disorders

Prescription contraception use and adherence by women with substance use disorders

Contraceptive Care in the Veterans Health Administration

Reproductive Health Management for the Care of Women Veterans

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