Details:

Alternative Title:
Surg Obes Relat Dis
Personal Author:
Shah, Jill P. ; Jatlaoui, Tara C. ; Zapata, Lauren B. ; Curtis, Kathryn M. ; Pagano, H. Pamela ; ... More +
Shah, Jill P. ; Jatlaoui, Tara C. ; Zapata, Lauren B. ; Curtis, Kathryn M. ; Pagano, H. Pamela ; Whiteman, Maura K. Less -
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:
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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
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:

Supporting Files

• nihms-1047131.nxml

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