Effectiveness of reproductive health counseling of women with systemic lupus erythematosus: observational cross-sectional study at an academic lupus clinic

Brites, Luísa; Silva, Stefanie; Andréoli, Laura; Inês, Luís

doi:10.1007/s00296-020-04671-9

Cited by 6 publications

(4 citation statements)

References 22 publications

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“…One of the main limitations of this study was the reliance on clinic notes and discharge paperwork to define contraception counselling. This could have led to the overestimation of contraception counselling in our population (80%), which deviates from most reports closer to 40% 4 13. Additionally, Silverstein et al found that 52% of patients who declined contraception were on a teratogenic medication 11.…”

Section: Discussioncontrasting

confidence: 55%

Teratogenic medication use associated with favourable odds of contraception counselling in a cohort of women with systemic lupus erythematosus at a large tertiary academic medical centre

et al. 2022

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ObjectiveSLE primarily affects women of childbearing age, who have an increased risk of pregnancy complications, especially in the setting of active disease. Contraception counselling is particularly important given the teratogenicity of some medications used for SLE treatment. Our study describes the frequency of contraception counselling provided by multiple subspecialties to women with SLE and investigates associations between teratogenic medication use and receiving contraception counselling.MethodsThis was a cross-sectional retrospective study of women (aged 15–46 years) diagnosed with SLE who were seen in various outpatient clinics at a large tertiary academic medical centre over a 2-year period. Demographic data were retrieved via the university-affiliated central data repository, and additional data, including documentation of contraception counselling, were obtained via manual chart abstraction. Univariable associations between variables and contraception counselling were assessed to produce unadjusted ORs and 95% CIs. Multivariable models were generated to evaluate independent associations between variables and contraception counselling.ResultsData from 478 women (52% African American, 25% Caucasian) with SLE were included. Rheumatology was the subspecialty to document contraception counselling most frequently (57%). Nearly 80% of women received counselling from at least one subspecialty, 44% from at least two. Factors associated with having lower odds of receiving contraception counselling were older age and Caucasian race. Women on teratogenic medications (methotrexate, mycophenolate mofetil/mycophenolic acid, cyclophosphamide) had higher odds of receiving contraception counselling from at least one subspecialty (OR 2.01; 95% CI 1.23 to 3.26), from two or more subspecialties (OR 2.18; 95% CI 1.50 to 3.17), and from rheumatology (OR 1.86; 95% CI 1.27 to 2.73).ConclusionsIn this study, women with SLE on teratogenic medications had higher odds of receiving contraception counselling from rheumatology and from at least two subspecialties. Multidisciplinary approaches to enhance contraception counselling should be encouraged.

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Section: Discussioncontrasting

confidence: 55%

Teratogenic medication use associated with favourable odds of contraception counselling in a cohort of women with systemic lupus erythematosus at a large tertiary academic medical centre

et al. 2022

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“…The importance of pregnancy planning and contraception counselling has been shown to positively increase women’s knowledge surrounding the impact of SLE on pregnancy. 12 Accordingly, the 2020 ACR Guidelines emphasise the importance of tailored contraception counselling based on each SLE patient’s clinical assessment (ie, antiphospholipid positivity). Our study demonstrated that women with a Spanish language preference had significant deficits as it related to in-clinic discussions regarding safe contraception use in light of their lupus diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Differences in reproductive health discussions in an urban Hispanic population with SLE: lessons from the field

Delgado,

Rodman,

Xepoleas

et al. 2024

Lupus Sci Med

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ObjectiveManagement of reproductive health-related issues is crucial for patients with SLE, given this is a disease that primarily affects women of childbearing age. Little is known as to how the 2020 American College of Rheumatology (ACR) Reproductive Health in Rheumatic Disease Guideline is experienced by an underserved, primarily Hispanic population and their physicians as it relates to pregnancy planning and contraception conversations. Given this population experiences high rates of unplanned pregnancies and worse SLE outcomes compared with the non-Hispanic white population, it is crucial to understand how reproductive health is discussed in this setting.MethodsA survey based on the 2020 ACR Reproductive Health Guideline was created and distributed in English and Spanish in the outpatient setting to 151 patients with SLE to determine patients’ beliefs, experiences and limitations with reproductive health discussions. Associations between categorical variables were evaluated using Pearson’s χ2or Fisher’s exact test, as appropriate, and differences in continuous variables were assessed using Wilcoxon rank-sum test.ResultsEnglish language survey respondents were significantly more likely to report having conversations regarding contraception, pregnancy planning and peripartum medication use than the Spanish survey respondents. Two-thirds of all respondents relied on the rheumatologist as a top source of reproductive health information.ConclusionDisparities exist regarding reproductive health conversations on multiple topics between English-speaking and Spanish-speaking populations with SLE. Further understanding is needed to clarify why reproductive health conversations occur at lower frequencies in Spanish-speaking SLE populations.

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“…But sexual health is often overlooked by healthcare providers. Those who have sexual health problems usually do not seek help for it (9,10). Therefore, it is important to evaluate sexual health during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Sex Education and Counseling Based on the Ex-PLISSIT Model on Sexual Life in Primigravidas

Altunbaş,

Gölbaşı

2024

Clinical and Experimental Health Sciences

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Objective: This study was conducted to determine the effect of sexual education and counseling based on the Ex-PLISSIT model on sexual function, attitudes towards sexuality during pregnancy, sexual distress, and quality of sexual life in primigravidas. Methods: This study was carried out on 62 primigravidas in a pretest posttest, a quasi-experimental control group. Primigravidas meeting the inclusion criteria were assigned to the groups by simple random sampling method. The intervention group received training and counseling sessions twice. The control group received routine care during the follow-up period. The results were compared with the evaluation forms 10 weeks after each training and counseling session. The forms were administered to the control group at the same time as the intervention group. Results: The mean scores of the intervention and control groups’ attitude towards sexuality during pregnancy in the second test (95%CI=2.33-19.01; d=0.65, p=.013) and in the posttest (95%CI=2.28-19.34; d=0.64, p=.015) were statistically significantly different. Sexual life quality scale mean scores of the intervention and control groups were statistically significant in the second test (95%CI=8.27-18.54; d=1.33, p=.000) and the posttest (95%CI=12.14-22.01; d=1.76, p=.000) level was different. In addition, the mean scores of the intervention group were higher after sexual education and counseling based on the Ex-PLISSIT model. Conclusion: In this study, sexual education and counseling based on the Ex-PLISSIT model positively affected primigravida’s attitudes towards sexuality and their quality of sexual life. Therefore, this model can be used as a cost-effective and simple counseling method to improve the sexual life.

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Effectiveness of reproductive health counseling of women with systemic lupus erythematosus: observational cross-sectional study at an academic lupus clinic

Cited by 6 publications

References 22 publications

Teratogenic medication use associated with favourable odds of contraception counselling in a cohort of women with systemic lupus erythematosus at a large tertiary academic medical centre

Teratogenic medication use associated with favourable odds of contraception counselling in a cohort of women with systemic lupus erythematosus at a large tertiary academic medical centre

Differences in reproductive health discussions in an urban Hispanic population with SLE: lessons from the field

The Effect of Sex Education and Counseling Based on the Ex-PLISSIT Model on Sexual Life in Primigravidas

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