Health Care Provider Knowledge Regarding Oral Contraception Effectiveness for Women with a History of Bariatric Malabsorptive Procedures
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Health Care Provider Knowledge Regarding Oral Contraception Effectiveness for Women with a History of Bariatric Malabsorptive Procedures

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  • English
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    Details:

    • Alternative Title:
      Surg Obes Relat Dis
    • Personal Author:
    • Description:
      Background:

      Clinical practice guidelines recommend women avoid pregnancy immediately after bariatric surgery, highlighting the need for effective contraception. However, women with a history of malabsorptive bariatric procedures should generally not use oral contraceptives, as these procedures may decrease contraceptive effectiveness.

      Objectives:

      To identify provider characteristics associated with knowledge of COC effectiveness.

      Setting:

      United States

      Methods:

      We analyzed weighted survey data collected from national samples of public-sector health centers and office-based physicians who regularly provide family planning services (n=2,060). We asked providers about the effectiveness of combined oral contraceptives (COCs) for women with a history of malabsorptive procedures compared with healthy women (more/equally effective, less effective, do not know). We used multinomial logistic regression to calculate adjusted odds ratios and 95% confidence intervals to identify characteristics associated with COC effectiveness knowledge.

      Results:

      Approximately 55% of providers correctly answered that COCs are less effective for women with malabsorptive procedures; 25% considered COCs more/equally effective, and 20% were uncertain. Among public-sector providers, the adjusted odds of uncertainty was significantly higher for those whose clinical focus was not reproductive health, for nurses versus advanced practice clinicians, and for those without Title X funding. For office-based physicians, adolescent medicine providers had higher odds of uncertainty versus obstetrician-gynecologists. Physicians practicing in settings other than private clinics (such as community health centers) had higher odds of considering COCs effective compared with those practicing in hospital or university clinics.

      Conclusions:

      Substantial proportions of surveyed providers have inadequate COC effectiveness knowledge for women with a history of malabsorptive procedures.

    • Subjects:
    • Source:
      Surg Obes Relat Dis. 15(8):1355-1361
    • Pubmed ID:
      31311756
    • Pubmed Central ID:
      PMC6721998
    • Document Type:
      Journal Article
    • Funding:
      CC999999/ImCDC/Intramural CDC HHS/United States
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