Contraception in adolescence: compliance to contraceptive methods
ESC Congress Library. Félix N. May 4, 2016; 126908; A-082
Nisa Félix
Nisa Félix
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Abstract
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Objectives: Evaluate the compliance to contraceptive methods, within 12 months and the adherence to the appointments at the adolescents' outpatient clinic.

Methods: We developed a retrospective study, based on the data collected from the clinical files of the adolescents' outpatient clinic (AOC) of Dr. Alfredo da Costa Maternity after contraceptive counselling and choice, between 2010 and 2013. The adherence to the AOC, the contraceptive choice and its compliance were evaluated at 3, 6 ant 12 months.

Results: 495 adolescents were included with a median age of 16 years (11 to 18 years); 70.1% (n=347) had at least one previous pregnancy, 37.4% (n=185) of which with a living child, and only 27% (n=136) were still studying.

346 (69.9%) adolescents were already using contraception, 95.4% (n=330) non long acting reversible contraceptives (LARC), mostly condom (47.7%, n=165) and estroprogestative pill (37.6%, n=130), and 4.6% (n=16) LARC (implant). After contraceptive counselling, 86.1% (n=298) users changed method; higher in non LARC users (89.4% versus 18.7%).

After the first appointment, 69% (n=297) opted to continue or chose LARC, mostly implant (59%, n=292). Only 1 patient continued using condom as single method and the estroprogestative pill became the most preferable non LARC (30.5%, n=151).

At 3 months, 29.3% (n=145) users were lost for follow-up. The remaining 70.7% (n=350) had 100% (228/228) compliance to LARC and 87.7% (107/122) to non LARC.

At 6 months of follow-up, 51.9% (n=257) came to the AOC. At this stage, the compliance to LARC was 95.8% (184/192) and non LARC 84.6% (55/65).

At 12 months, 42.2% (n=209) kept the follow-up. The LARC compliance was 94.8% (164/173) and non LARC 94.4% (34/36).

Conclusions: After counseling most adolescents changed method (86.1%) and the preferable contraceptive choice was the implant (59%). In the group of non LARC, the estroprogestative pill was the most chosen (30.5%).

LARC users had less dropout to AOC (41.6%), comparing to non LARC (81.8%).

Given the high dropout rate, it was not possible to assess the true compliance to the different contraceptives methods, but in the adolescents who kept the follow-up during 12 months, the compliance was 94.7% (164 of 173) to LARC and surprisingly 94% (34 of 36) to non LARC, contrary to the published in many international studies.

 

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