Details:

Alternative Title:
Contraception
Personal Author:
Steenland, Maria W. ; Zapata, Lauren B. ; Brahmi, Dalia ; Marchbanks, Polly A. ; Curtis, Kathryn M.
Steenland, Maria W. ; Zapata, Lauren B. ; Brahmi, Dalia ; Marchbanks, Polly A. ; Curtis, Kathryn M. Less -
Description:
Background

We conducted a systematic review to assess whether follow-up visits or contacts after a woman begins using contraception improve method continuation and correct use.

Study Design

We searched the PubMed database for all peer-reviewed articles in any language published from database inception through May 2012 that examined the effect of a structured follow-up schedule of visits or contacts on contraceptive use. We included studies that compared women who initiated a method of contraception with a certain follow-up schedule compared to women with a different follow-up schedule or no follow-up at all. To be included, studies must have compared groups on a measure of contraceptive use (e.g., pregnancy, correct use, consistent use, method discontinuation including expulsion). Though not ideally suited to answer our review question, studies in which women used a variety of contraceptive methods but results were not stratified by method type were included.

Results

Four studies met our inclusion criteria (Level I, poor to II-2, poor). Two studies examined the effect of a specific follow-up visit schedule on intrauterine device (IUD) continuation: one examining frequency of visits and one examining the timing of the first follow-up visit. Women with more frequent follow-up visits did not have a statistically significant difference in proportion of removals for medical reasons compared with women who had fewer follow-up visits; among women who had their IUDs removed for medical reasons, those who had more frequent follow-up visits had a longer mean time of use prior to removal. The other study found more removals and shorter continuation among women with a follow-up visit at 1 week compared to women with a follow-up visit at 1 month after IUD insertion (no statistical tests reported). Two studies examined the effect of follow-up phone calls compared to no follow-up phone calls after an initial family planning visit among adolescents initiating a variety of contraceptive methods. Neither of the two studies found any differences in method continuation or correct use between study groups.

Conclusions

It is difficult to determine what effect, if any, follow-up visits or contacts have on contraceptive method continuation or correct use. Few studies were identified, and those that were identified were mostly of poor quality, were not method specific and had either poor patient compliance with follow-up visits or poor phone contact completion rates.


Subjects:
[+]
Article Continuation Contraception Contraceptive Agents Correct Use Female Follow-up Humans Medication Adherence Office Visits Service Use
Source:
Contraception. 2013; 87(5):625-630.
Pubmed ID:
23114736
Pubmed Central ID:
PMC4451942
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:b7448cd17b6f5466fcc5f1cab8ec92d077c328e1dd9b37cde84dbb7cb0ab5436
Download URL:
https://stacks.cdc.gov/view/cdc/33761/cdc_33761_DS1.pdf
File Type:

Supporting Files

• nihms691702.nxml

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