期刊
OBSTETRICS AND GYNECOLOGY
卷 117, 期 5, 页码 1105-1113出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/AOG.0b013e31821188ad
关键词
-
资金
- anonymous foundation
- Midcareer Investigator Award in Women's Health Research [K24 HD01298]
- Clinical and Translational Science Award [UL1RR024992]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) [K12HD001459]
- National Center for Research Resources (NCRR), National Institutes of Health (NIH) and NIH Roadmap for Medical Research [KL2RR024994]
- Society of Family Planning
- ACOG/Bayer Healthcare Pharmaceuticals
OBJECTIVE: To estimate 12-month satisfaction and continuation rates of intrauterine device (IUD) and implant users enrolled in the Contraceptive CHOICE Project and compare these measures with women using the oral contraceptive pills (OCPs). METHODS: We analyzed 12-month data from the first 5,087 participants enrolled in a prospective cohort study of women in the St. Louis region offered contraception at no cost for 3 years. The primary purpose of CHOICE is to promote the use of long-acting reversible contraception (IUDs and implants) and to reduce unintended pregnancies in our region. This analysis includes those participants who received their baseline contraceptive method within 3 months of enrollment and who reached the 12-month follow-up telephone survey time point (n=4,167). RESULTS: Sixty-eight percent of our participants chose a long-acting reversible contraception method (45% levonorgestrel intrauterine system, 10% copper IUD, and 13% subdermal implant), 23% chose combined hormonal methods (11% OCPs, 10% vaginal ring, and 2% transdermal patch), and 8% chose depot medroxyprogesterone acetate. Long-acting reversible contraception users had higher 12-month continuation rates (86%) than OCP users (55%). The two IUDs had the highest 12-month continuation rates: levonorgestrel intrauterine system (88%) and copper IUD (84%). Women using the implant also had very high rates of continuation at 1 year (83%). Satisfaction mirrored continuation: more than 80% of users were satisfied with the IUD compared with 54% satisfied with OCPs. CONCLUSION: IUDs and the subdermal implant have the highest rates of satisfaction and 12-month continuation. Given that long-acting reversible contraception methods have the highest contraceptive efficacy, these methods should be the first-line contraceptive methods offered to patients. (Obstet Gynecol 2011; 117: 1105-13) DOI: 10.1097/AOG.0b013e31821188ad
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