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

Abstract

BackgroundAdequate 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.MethodsWomen 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.ResultsAfter 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 %).ConclusionsCounselling 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 registrationNCT01181778, Trial registration date: August 12, 2010Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-015-0226-x) contains supplementary material, which is available to authorized users.

Women's perceptions and treatment patterns related to contraception: results of a survey of US women

“…In this study, the type of clinician and whether patients received counseling from their clinician influenced choice of prescription method, highlighting the importance of the patient-HCP relationship. In previous studies, b20% of primary care providers offered IUDs [9,10], while over 95% of OB/GYNs did [11], and patients counseled on the ease of use and administration of various methods were more likely to choose methods other than OC [12,13]. Interestingly, there were no statistical differences in the proportions of women dissuaded from using particular prescription methods based on age, race/ethnicity, or parity.…”

Knowledge of Midwives on IUD Counseling

“…(Dehlendorf et al, 2016) Counseling can also help anticipate events that often arise after starting a particular contraceptive method, place expectations according to the possible effects and reduce the demand for meeting providers after contraceptive use. (Gambera et al, 2015) However, the result fact of family planning counseling in Indonesia has not been as expected. The results of the research in Kebumen showed that 31.3% of midwives' knowledge was less about IUD contraception; 5% of them forget or don't know about the working mechanism of the IUD; 11.3% forgot about the effectiveness, side effects, complications, and duration of IUD use; 31.3% of midwives have low motivation regarding IUD contraceptive services; 40% of midwives prefer to serve injection acceptors and put up implants rather than providing an IUD for practical and easier reasons.…”

Reasons for hormonal contraceptive use in a cohort of African-American women living in the Detroit area

“…In the 1990s and early 2000s, the U.S. saw a dramatic increase in the number of available HCs, from the initial approvals of implantable and injectable contraceptives (referred to as long-acting reversible contraceptives, or LARC) to the introduction of the patch and the ring [3,5]. In this new context, contraceptive selection is related to convenience, cost, side effects, peer utilization, and awareness of method [6,7], and many women try more than one HC route in their lifetime [3]. Yet, studies of reasons for HC use are relatively limited, and mainly concern reasons for choosing one HC type over another in the context of family planning [6,7], as opposed to clinical indication(s) for use, and most focus on oral contraceptive use.…”

“…In this new context, contraceptive selection is related to convenience, cost, side effects, peer utilization, and awareness of method [6,7], and many women try more than one HC route in their lifetime [3]. Yet, studies of reasons for HC use are relatively limited, and mainly concern reasons for choosing one HC type over another in the context of family planning [6,7], as opposed to clinical indication(s) for use, and most focus on oral contraceptive use. Such data are especially limited for African Americans because even if included, findings are not reported stratified by race [8].…”