Current evidence of contraceptive uptake, pregnancy and continuation rates in young women: a systematic review and Meta-analysis

Farah, Daniela; Andrade, Teresa Raquel; Bella, Zsuzsanna Ilona Katalin de Jármy Di; Girão, Manoel Joâo Batista Castello; Fonseca, Marcelo Cunio Machado

doi:10.1080/13625187.2020.1833187

Cited by 7 publications

(7 citation statements)

References 50 publications

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“…While these findings may infer the appropriateness of the video content to support contraceptive choice, we observed a decline in satisfaction among IUD users across timepoints. LARC generally have high rates of continuation and attributes that make them desirable to many young people including their high effectiveness and generally acceptable side effect profiles 24–26. While videos that emphasise the benefits of LARC (primarily relating to their high effectiveness compared with other reversible methods) may increase LARC uptake,21 we note that the strongest desire to prevent pregnancy does not always correspond to a preference for the most effective methods 27–29.…”

Section: Discussionmentioning

confidence: 85%

Can an online educational video broaden young women’s contraceptive choice? Outcomes of the PREFER pre-post intervention study

Mazza

Buckingham

McCarthy

et al. 2022

BMJ Sex Reprod Health

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IntroductionContraceptive knowledge mediates access and use. We aimed to assess whether an online educational video describing all methods and their benefits, side effects and mode of action increased young women’s contraceptive knowledge and their long-acting reversible contraception (LARC) preference and uptake.MethodWe used Facebook advertising to recruit young women aged 16–25 years. Participants completed the pre-video survey (S1), watched the 11-min video, then completed surveys immediately after (S2) and 6 months later (S3). Outcomes were analysed using McNemar tests and multivariate logistic regression (generalised estimating equations).ResultsA total of 322 participants watched the video, completed S1 and S2, and 88% of those completed S3. At S1 only 6% rated their knowledge about every method as high. Knowledge improved at S2 for all methods (OR 10.0, 95% CI 5.9 to 17.1) and LARC (OR 4.2, 95% CI 3.1 to 5.7). LARC preference increased at S2 (OR 1.7, 95% CI 1.4 to 2.1) and S3 (OR 1.4, 95% CI 1.2 to 1.7), as did LARC uptake at S3 (OR 1.3, 95% CI 1.11 to 1.5). LARC uptake was driven by a 4.3% (n=12) absolute increase in intrauterine device (IUD) use, but there was no change in contraceptive implant use (p=0.8). The use of non-prescription methods such as condoms and withdrawal did not change (OR 0.92, 95% CI 0.76 to 1.11).ConclusionsMany young women in Australia do not feel well informed about their contraceptive options. The contraceptive education video, delivered via social media, increased their self-reported contraceptive knowledge and IUD preference immediately after viewing, and their IUD uptake 6 months later. Focus should be given to how young women navigate contraceptive access after internet-based education, and strategies to increase access to preferred methods.

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Section: Discussionmentioning

confidence: 85%

Can an online educational video broaden young women’s contraceptive choice? Outcomes of the PREFER pre-post intervention study

Mazza

Buckingham

McCarthy

et al. 2022

BMJ Sex Reprod Health

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“…In this scenario, when poor adherence is identified, the option of using long-acting reversible contraception (LARC) methods, which include the implant, the hormonal IUD, and the copper IUD, is raised, since their effectiveness is close to 99% despite user noncompliance or incorrect use [43]. However, the results of a meta-analysis on contraceptive effectiveness showed that despite the advantages of LARC methods, young women continued mostly to use SARC methods [44].…”

Section: Discussionmentioning

confidence: 99%

Medication Adherence and Contraceptive Counseling

de Molina-Fernandez,

Reyes-Martí,

De la Flor-López

et al. 2023

Healthcare

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Combined oral contraceptives (COC) are a very popular form of birth control. Incorrect use and lack of adherence to treatment reduce the effectiveness of this method. Having a standard tool to identify poor-adherence profiles quickly and objectively can be helpful for midwives and potentially for COC users. The MMAS-4 adherence scale has been used in various medical fields, but there is little evidence of its potential in contraceptive consultation. This paper presents a piece of multicenter observational research based on a sample of 327 women who had attended contraceptive counselling in Spain and were COC users or had informed the midwife that they want to start to use this method. Two interviews were conducted: at the time of consultation and after one year. In our research, the MMAS-4 identified high-risk behaviors: during the 1-year follow-up period, COC users classified as poorly adherent had a significantly higher risk of missed contraceptive pills, more incidents and problems related to the method of contraception, as well as a lower degree of satisfaction with the contraceptive method. One case of unplanned pregnancy and two cases of emergency contraception were identified, all of them corresponding to poorly adherent women. The use of MMAS-4 in consultation can improve midwives’ contraceptive counselling.

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“…In accordance with real conditions in Brazil, market shares of 81.0% and 82.6% for LNG-IUS and ENG, respectively, were also accounted for in the calculations [ 39 ]. The costs of adverse events were not accounted for in regard to either method because a recent meta-analysis found no significant differences in safety between these techniques [ 5 ].…”

Section: Methodsmentioning

confidence: 99%

“…In terms of absolute numbers, implants have been shown to outperform other contraceptive methods. However, LARCs are not commonly used in practice [ 4 , 5 ]. Etonogestrel-releasing subdermal contraceptive implants have a lower failure rate than hormonal contraceptives or copper intrauterine devices (IUDs), resulting in a lower incidence and probability of unintended pregnancy [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Etonogestrel-releasing subdermal contraceptive implants have a lower failure rate than hormonal contraceptives or copper intrauterine devices (IUDs), resulting in a lower incidence and probability of unintended pregnancy [ 6 , 7 ]. These implants demonstrate a higher efficacy than IUDs in young women, as indicated by their high rate of pregnancy prevention [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Etonogestrel-releasing subdermal contraceptive implant: Budget impact analysis based on the Brazilian private healthcare system

Lopes da Silva Filho,

Luis Pereira Bueno,

Ramires

et al. 2024

PLoS ONE

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High rates of unplanned pregnancies persist despite pharmacological developments and advancements in contraceptive methods. Here, we demonstrate that the etonogestrel-releasing subdermal contraceptive implant (IMP-ETN) may be an appropriate and cost-effective alternative to levonorgestrel-releasing intrauterine systems (LNG-IUSs) for women in Brazil. For our pharmacoeconomic analysis, we reviewed the literature on IMP-ETN regarding its acceptance, eligibility criteria, choice, relations with age, adverse events and, finally, the unmet need in the fee-for-service private healthcare sector. We considered qualitative observations in combination with quantitative analysis and performed a deterministic sensitivity analysis to investigate whether this technology can be self-sustainable over a period of five years. The target population for this analysis comprised 158,696 women. Compared with the continued use of LNG-IUSs, adopting the IMP-ETN can result in a cost avoidance of $ 7.640.804,02 in the first year and $ 82,455,254.43 in five years. Disseminating information among physicians will promote this change and strengthen the potential cost avoided by private health system payers. These savings can be used to improve other healthcare programs and strategies. Moreover, the principles of care can be promoted by improving and adapting healthcare systems and expanding treatment and follow-up strategies. This would also provide support to women’s reproductive rights and improve their quality of life. Our results suggest that the IMP-ETN has a favorable cost-effectiveness profile. Given all its advantages and negative incremental cost impact over a period of five years, the IMP-ETN may be a more favorable alternative to LNG-IUSs. Therefore, it should be offered to beneficiaries with a private healthcare plan. This analysis overcomes previous barriers to the use of cost-benefit models, and our results may help balance decision-making by policymakers, technical consultants, and researchers.

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Current evidence of contraceptive uptake, pregnancy and continuation rates in young women: a systematic review and Meta-analysis

Cited by 7 publications

References 50 publications

Can an online educational video broaden young women’s contraceptive choice? Outcomes of the PREFER pre-post intervention study

Can an online educational video broaden young women’s contraceptive choice? Outcomes of the PREFER pre-post intervention study

Medication Adherence and Contraceptive Counseling

Etonogestrel-releasing subdermal contraceptive implant: Budget impact analysis based on the Brazilian private healthcare system

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