Adherence to guidelines high for patients with medical contraindications to oral contraceptives
THURSDAY, Sept. 26, 2019 (HealthDay News) — Telecontraception — the provision of contraception through a website or smartphone app — is feasible and seems safe for patients, according to a research letter published in the Sept. 26 issue of the New England Journal of Medicine.
Tara Jain, A.B., from Harvard Medical School in Boston, and colleagues recruited seven standardized patients with characteristics representing a range of relative and absolute contraindications to oral contraceptives or with difficulty adhering to daily pill ingestion. Patients presented to nine telecontraception vendors and completed 63 visits, during which they requested oral contraceptives.
The researchers found that each visit lasted a mean of 7.5 minutes and included questionnaire completion. After completion of the questionnaire, two vendors immediately provided a video call. In 32 percent of visits, there was a follow-up interaction. Patient-provider interaction was not required by three vendors. A prescription was sent to a local pharmacy electronically on the same day as the visit or mailed to the patient’s house within seven days. For an uninsured patient, the mean total cost for a 12-month prescription was $313. Adherence to Medical Eligibility Criteria for Contraceptive Use guidelines was 93 percent in the 45 visits in which there was a medical contraindication to oral contraceptives; in three visits, oral contraceptives were prescribed when contraindicated. Screening for patient ability to ingest a pill daily was not provided; two companies mentioned long-active reversible contraceptive methods.
“These findings suggest that telecontraception may reduce barriers to contraception because vendors are convenient and accessible,” the authors write.
One author disclosed receiving personal fees from the Planned Parenthood Federation of America.
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