Long-Acting Reversible Contraception for Adolescents and Young Adults – A Cross-Sectional Study of Women and General Practitioners in Oslo, Norway.
ESC Congress Library. Bratlie M. 05/28/14; 50581; A-166
Marte Bratlie
Marte Bratlie
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Abstract
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Objectives: To investigate the current state of long-acting reversible contraception (LARC; i.e. implants, intrauterine devices/systems [IUD/S]) use and awareness in the Norwegian primary care sector. Methods: Use, knowledge and impression of contraceptive methods, and content of contraceptive counseling was investigated by use of anonymous questionnaires in women aged 16-23 years (n=359), and by anonymous web-based questionnaires among medical general practitioners (GPs; n=140) in Oslo, Norway. Multiple comparisons were performed using Kruskal-Wallis analysis of variance with Dunn’s post-hoc testing or Chi-square tests. Multivariable binary logistic regression was used to identify determinants of various LARC outcomes amongst both groups of participants. A two-sided p-value <0.05 was considered significant. Results: Of the 295 (82%) current contraceptors, 34 (11.5%) women were LARC users. Combined oral contraceptives (COC; n=165, 56%) and condom only (n=61, 21%) were the predominant methods used. The women reported good knowledge of condoms and COCs, but poor or average knowledge of all other methods. Knowledge of LARC and previous contraceptive use were independent predictors of current LARC use (p<0.001 and p=0.048). Approximately 35% of the GPs often included LARC methods in counseling, whereas COCs were often included by 93%. The GPs reported a high self-perceived knowledge of all contraceptive methods and had an unfavorable impression of LARC methods for use in the 16-23 year age group. A lack of insertion training was inversely associated with frequent inclusion of implants in counseling (OR 0.12, p=0.013). The main determinant for omitting IUD and IUS in counseling was nulliparity (OR 0.2, p=0.001 and <0.001, respectively). Conclusion: LARC use is low among 16-23 year olds in Oslo, Norway, who need better counseling on their contraceptive options. Amelioration of misconceptions and improvement of provider training could see more GPs including LARC methods in contraceptive counseling.



 

Objectives: To investigate the current state of long-acting reversible contraception (LARC; i.e. implants, intrauterine devices/systems [IUD/S]) use and awareness in the Norwegian primary care sector. Methods: Use, knowledge and impression of contraceptive methods, and content of contraceptive counseling was investigated by use of anonymous questionnaires in women aged 16-23 years (n=359), and by anonymous web-based questionnaires among medical general practitioners (GPs; n=140) in Oslo, Norway. Multiple comparisons were performed using Kruskal-Wallis analysis of variance with Dunn’s post-hoc testing or Chi-square tests. Multivariable binary logistic regression was used to identify determinants of various LARC outcomes amongst both groups of participants. A two-sided p-value <0.05 was considered significant. Results: Of the 295 (82%) current contraceptors, 34 (11.5%) women were LARC users. Combined oral contraceptives (COC; n=165, 56%) and condom only (n=61, 21%) were the predominant methods used. The women reported good knowledge of condoms and COCs, but poor or average knowledge of all other methods. Knowledge of LARC and previous contraceptive use were independent predictors of current LARC use (p<0.001 and p=0.048). Approximately 35% of the GPs often included LARC methods in counseling, whereas COCs were often included by 93%. The GPs reported a high self-perceived knowledge of all contraceptive methods and had an unfavorable impression of LARC methods for use in the 16-23 year age group. A lack of insertion training was inversely associated with frequent inclusion of implants in counseling (OR 0.12, p=0.013). The main determinant for omitting IUD and IUS in counseling was nulliparity (OR 0.2, p=0.001 and <0.001, respectively). Conclusion: LARC use is low among 16-23 year olds in Oslo, Norway, who need better counseling on their contraceptive options. Amelioration of misconceptions and improvement of provider training could see more GPs including LARC methods in contraceptive counseling.



 

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