Use of a video tool for intrauterine contraceptive counselling as an alternative to face-to-face counselling
ESC Congress Library. Bignall J. 05/10/18; 208226; ESC16
Dr. Jenine Bignall
Dr. Jenine Bignall
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Introduction Women requesting intrauterine contraception (IUC) often endure multiple clinic attendances for pre-fitting counselling and preparation. For many, this is inconvenient and may delay timely access to effective reliable contraception. Objectives We devised an educational IUC video for patient use as an alternative to 'face-to-face' counselling. Methods We conducted a 4-week pilot study. Women contacting our clinic requesting IUC were assigned to two groups: face-to-face or 'Traditional Counselling' (TC); which was our current clinic practice or IUC Video Counselling (VC). The VC patients were sent a SMS with a link to the video prior to attending for fitting. Data were collected from patient records and questionnaires completed both pre and post IUC fitting. Results 113 women attended for an IUC fitting during the study period. 64 were assigned to VC and 49 to TC. 78% and 86% of women had IUC successfully fitted in the VC and TC groups respectively.  In both groups, pregnancy risk was the main reason for abandoned fitting. Pre-fitting; 51% women in the VC group felt 'extremely well prepared' compared with 27% receiving TC. At 6-weeks post-fitting; 50% and 43% of women reported no issues with their IUC in the VC and TC groups respectively. 100% women in the VC group and 86% women in the TC group still had their IUC in situ. 83% women in both groups stated they would recommend an IUC to family and friends. Discussion Attendance rates in both groups are comparable with slightly fewer cancellations in the VC group. STI screening results were negative in both groups demonstrating that existing infection prior to fitting is rare and a 'screen & fit' approach is safe and acceptable. Successful fitting in both groups is comparable with slightly more successful fittings in the TC group. On further analysis, pregnancy risk is the commonest reason for failed/abandoned fitting and is equal in both groups. Recommendations A clear patient friendly website with access to the video, patient information leaflet and pre-fit checklist emphasising in particular pregnancy risk is required and has since been developed. Conclusions Ease of accessibility to IUC is important; and with the increasing use of online educational information; patients appear willing to accept this as an alternative to more 'traditional' face-to-face consultations with no evidence of poorer satisfaction or early discontinuation of the method. 
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