Strategies to improve adherence and acceptability of hormonal methods of contraception

Abstract

Most studies to date have shown no benefit of strategies to improve adherence and continuation. These trials have important limitations, however. Three had small sample sizes, four had high losses to follow up, and the intervention and its intensity varied across the studies. High-quality research is a priority, since adherence and continuation are fundamentally important to the successful use of hormonal contraceptives.

Incidence and determinants of Implanon discontinuation: Findings from a prospective cohort study in three health zones in Kinshasa, DRC

“…Dissatisfaction with bleeding patterns was the most common reason for early discontinuation, which is consistent with previous other studies [30,31]. Counselling women on expected bleeding patterns has been shown to improve continuation rates for injectables and implant [30][31][32][33][34][35][36]. In this study, bleeding duration emerged as an important predictor of…”

Incidence and determinants of Implanon discontinuation: Findings from a prospective cohort study in three health zones in Kinshasa, DRC

“…Dissatisfaction with bleeding patterns was the most common reason for early discontinuation, which is consistent with previous other studies [30,31]. Counselling women on expected bleeding patterns has been shown to improve continuation rates for injectables and implant [30][31][32][33][34][35][36]. In this study, bleeding duration emerged as an important predictor of…”

Continuation Rates and Complications of Intrauterine Contraception in Women Diagnosed With Bipolar Disorder

“…Similarly, some studies in US women have reported 12-month continuation rates on DMPA ranging from 21.3% to 28.6% (26)(27)(28). In line with our findings, another study generated from a different U.S. insurance claims database indicates that nearly 60% of new DMPA users did not receive a second injection at 3 months (29)(30). Perhaps differences in study settings, such as international versus U.S. populations, and formal clinical research studies versus actual use as documented in medical claims data, have contributed to the wide range of continuation rates reported for DMPA.…”

Planned, unplanned and in-between: the meaning and context of pregnancy planning for young people

“…These findings are in line with previous research indicating that pregnancy planning may not be salient to all individuals and that religion, culture, and social position may influence the degree of control an individual feels they have over pregnancy planning [3,4,11,34–36]. These findings may help contextualize the lack of success of interventions aimed at increasing adherence to contraceptive use [40]. Researchers have critiqued these interventions for their tendency to ignore women’s own perceptions about pregnancy intention and planning [5,37] and called for more patient-centered approaches, as these interventions may prioritize normative perceptions of readiness for pregnancy and parenting and alienate some women [41,42].…”

Incidence and determinants of Implanon discontinuation: Findings from a prospective cohort study in three health zones in Kinshasa, DRC

“…Dissatisfaction with bleeding patterns was the most common reason for early discontinuation, which is consistent with previous other studies [30,31]. Counselling women on expected bleeding patterns has been shown to improve continuation rates for injectables and implant [30][31][32][33][34][35][36]. In this study, bleeding duration emerged as an important predictor of…”

Continuation Rates and Complications of Intrauterine Contraception in Women Diagnosed With Bipolar Disorder

“…Similarly, some studies in US women have reported 12-month continuation rates on DMPA ranging from 21.3% to 28.6% (26)(27)(28). In line with our findings, another study generated from a different U.S. insurance claims database indicates that nearly 60% of new DMPA users did not receive a second injection at 3 months (29)(30). Perhaps differences in study settings, such as international versus U.S. populations, and formal clinical research studies versus actual use as documented in medical claims data, have contributed to the wide range of continuation rates reported for DMPA.…”

Planned, unplanned and in-between: the meaning and context of pregnancy planning for young people

“…These findings are in line with previous research indicating that pregnancy planning may not be salient to all individuals and that religion, culture, and social position may influence the degree of control an individual feels they have over pregnancy planning [3,4,11,34–36]. These findings may help contextualize the lack of success of interventions aimed at increasing adherence to contraceptive use [40]. Researchers have critiqued these interventions for their tendency to ignore women’s own perceptions about pregnancy intention and planning [5,37] and called for more patient-centered approaches, as these interventions may prioritize normative perceptions of readiness for pregnancy and parenting and alienate some women [41,42].…”

Incidence and determinants of Implanon discontinuation: Findings from a prospective cohort study in three health zones in Kinshasa, DRC

“…Dissatisfaction with bleeding patterns was the most common reason for early discontinuation, which is consistent with previous other studies [30,31]. Counselling women on expected bleeding patterns has been shown to improve continuation rates for injectables and implant [30][31][32][33][34][35][36]. In this study, bleeding duration emerged as an important predictor of…”

Continuation Rates and Complications of Intrauterine Contraception in Women Diagnosed With Bipolar Disorder

“…Similarly, some studies in US women have reported 12-month continuation rates on DMPA ranging from 21.3% to 28.6% (26)(27)(28). In line with our findings, another study generated from a different U.S. insurance claims database indicates that nearly 60% of new DMPA users did not receive a second injection at 3 months (29)(30). Perhaps differences in study settings, such as international versus U.S. populations, and formal clinical research studies versus actual use as documented in medical claims data, have contributed to the wide range of continuation rates reported for DMPA.…”

Planned, unplanned and in-between: the meaning and context of pregnancy planning for young people

“…These findings are in line with previous research indicating that pregnancy planning may not be salient to all individuals and that religion, culture, and social position may influence the degree of control an individual feels they have over pregnancy planning [3,4,11,34–36]. These findings may help contextualize the lack of success of interventions aimed at increasing adherence to contraceptive use [40]. Researchers have critiqued these interventions for their tendency to ignore women’s own perceptions about pregnancy intention and planning [5,37] and called for more patient-centered approaches, as these interventions may prioritize normative perceptions of readiness for pregnancy and parenting and alienate some women [41,42].…”