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

  • Published Date:

    June 17 2019

  • Source:
    Surg Obes Relat Dis. 15(8):1355-1361
  • Language:
    English
Filetype[PDF-92.66 KB]


Details:
  • Alternative Title:
    Surg Obes Relat Dis
  • 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.
  • Pubmed ID:
    31311756
  • Pubmed Central ID:
    PMC6721998
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