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

Details

• Alternative Title:
  Surg Obes Relat Dis
• Personal Author:
  Shah, Jill P. ; Jatlaoui, Tara C. ; Zapata, Lauren B. ; Curtis, Kathryn M. ; Pagano, H. Pamela ; Whiteman, Maura K.
• 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:
  Article Bariatric Surgery Oral Contraception Effectiveness
• 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
• Volume:
  15
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:16745795dcc86b61e4db2c68ecfd6ad874baeaa914c577739e9894f4b466de0a
• Download URL:
  https://stacks.cdc.gov/view/cdc/81234/cdc_81234_DS1.pdf
• File Type:
  [PDF - 92.66 KB ]