Strategies to improve adherence and continuation of shorter-term hormonal methods of contraception

Mack, Natasha; Crawford, Tineke J; Guíse, Jeanne Marie; Chen, Mario; Grey, Tom; Feldblum, Paul J.; Stockton, Laurie L; Gallo, Maria F

doi:10.1002/14651858.cd004317.pub5

Cited by 39 publications

(36 citation statements)

References 73 publications

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“…A recent Cochrane review did not find significant differences amongst hormonal contraception, levonorgestrel releasing system (LNG-IUS), and copper intrauterine device (Cu-IUD), although the studies were small, and of low to moderate quality (35). Anticipatory discussion around anticipated menstrual side effects can reduce discontinuation of the shorter acting methods (36).…”

Section: Contraceptive Counsellingmentioning

confidence: 99%

“…Absolute and relative contraindications should be reviewed prior to initiation (4,17). Common side effects including unscheduled bleeding, nausea, and headaches, should be discussed with the adolescent prior to initiation, as this improves continuation (36). Adolescents and young women can be counselled that they can take the CHC with a 4-or 7-day HFI, and/or can take cyclically or in extended cycle (Skipping periods).…”

Section: Combined Hormonal Contraceptionmentioning

confidence: 99%

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Contraception for Adolescents

Todd¹,

Black²

2020

Jcrpe

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Although pregnancy and abortion rates have declined in adolescents, unintended pregnancies remain unacceptably high in this age group. The use of highly effective methods of contraception is one of the pillars of unintended pregnancy prevention and requires a shared decision making process within a rights based framework. Adolescents are eligible to use any method of contraception and long-acting reversible contraceptives, which are "forgettable" and highly effective, may be particularly suited for many adolescents. Contraceptive methods may have additional non-contraceptive benefits that address other needs or concerns of the adolescent. Dual method use should be encouraged among adolescents for the prevention of both unintended pregnancies and sexually transmitted infections. Health care providers have an important role to play in ensuring that adolescents have access to high quality and non-judgmental reproductive health care services and contraceptive methods in adolescent-friendly settings that recognize the unique biopsychosocial needs of the adolescent. Abstract 28

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Section: Contraceptive Counsellingmentioning

confidence: 99%

Section: Combined Hormonal Contraceptionmentioning

confidence: 99%

Contraception for Adolescents

Todd¹,

Black²

2020

Jcrpe

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“…However, the quality of healthcare interactions varies by provider, leading to disparities in counseling and provision of services for family planning [9,11,12]. Poor provider interactions may result in decreased use of health services, and higher discontinuation and dissatisfaction with services [13][14][15]. Understanding the ways that women's interactions with health providers shape their family planning decision-making is important to maximizing the quality and use of family planning services for all women throughout the life course.…”

Section: Introductionmentioning

confidence: 99%

“You better use the safer one… leave this one”: the role of health providers in women’s pursuit of their preferred family planning methods

et al. 2020

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Background: Universal access to quality sexual and reproductive health (SRH) services is pivotal to ensuring gender equality. In high-income countries, patient-provider interactions have been shown to shape women's decisions about contraception, with poor exchanges decreasing method uptake and satisfaction. While significant progress has been made to increase women's access to SRH services, in low-and middle-income countries, little is known about the quality of family planning patient-provider interactions. The primary objective of this analysis was to explore the role of health care providers in women's family planning decision-making in Ethiopia. Methods: From July to August 2017, 10 focus group discussions (n = 80) and 30 in-depth interviews were conducted with women aged 15-49 and men aged 18+ recruited via purposive sampling from urban and rural sites in Ethiopia. Semi-structured interview guides explored women's and girls' empowerment in SRH surrounding sex, childbearing, and contraception. All interviews were conducted in Amharic, audio-recorded, and transcribed verbatim into English. Inductive thematic analysis was used to analyze data. Eleven codes specific to provider services for family planning were reviewed and matrixes creates for synthesis. Results: Three primary themes emerged: the role of providers in women's awareness of and demand for family planning services; selection and uptake of contraceptive methods; and discontinuation and switching of contraceptive methods. Results indicate that health extension workers were central to women's awareness of family planning, and health providers' endorsements were instrumental in decisions to adopt methods. The majority of respondents described positive interactions with providers and appreciated thorough counseling when considering using or switching methods. Some women, however, described health providers directing them toward long-acting methods by communicating inaccurate information or emphasizing disadvantages of short-acting methods. A few women described provider reluctance or resistance to switching methods, especially from implants.

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“…In the literature, few studies focused on the effect of family planning interventions on discontinuation and switching. We found three systematic reviews which concluded to a low level of evidence on the effect of the strategies to improve continuation of hormonal methods of contraception [14][15][16]. Halpern et al, in 2013, reported that only three trials showed some bene t of strategies to improve adherence and continuation.…”

Section: Introductionmentioning

confidence: 99%

“…For Mack et al, 2019, intensive counseling and reminders (with or without educational information) may be associated with the improved continuation of shorter-term hormonal contraceptive methods when compared with usual family planning care. However, this should be interpreted with caution due to the low certainty of the evidence [15]. Cavallaro et al, in 2013, conducted a systematic review of the strategies to improve adherence and acceptability of hormonal methods of contraception.…”

Section: Introductionmentioning

confidence: 99%

Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the DRC: a secondary analysis of the Yam-Daabo trial

Coulibaly

Millogo²,

Baguiya

et al. 2020

Preprint

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Introduction : Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).

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Strategies to improve adherence and continuation of shorter-term hormonal methods of contraception

Abstract: Editorial group: Cochrane Fertility Regulation Group. Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 4, 2019.

Cited by 39 publications

References 73 publications

Contraception for Adolescents

Contraception for Adolescents

“You better use the safer one… leave this one”: the role of health providers in women’s pursuit of their preferred family planning methods

Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the DRC: a secondary analysis of the Yam-Daabo trial

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