\nWe summarize the week’s scientific breakthroughs every Thursday.<\/p>\n
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\u201cThis shows that patients actually don\u2019t have to choose between something that they like and something that they need \u2014 very often, one method can be both,\u201d says Katharine White, chief of obstetrics and gynecology at Boston Medical Center, who was not involved in the study. \u201cThis is not trying to put down any method. It\u2019s about opening the scope and expanding our view\u201d of options that meet people\u2019s values, she says.<\/p>\n
The HER Salt Lake study, conducted by a research team from the University of Utah, included four Salt Lake City family planning clinics. The study was open to people who could become pregnant ages 16 to 45 and whose incomes were below the federal poverty threshold. Included participants planned to avoid pregnancy for at least a year and were either a new patient wanting contraception or an established patient seeking a new method.<\/p>\n
There was a choice of seven reversible birth control methods: the copper intrauterine device, or IUD, hormonal IUD, contraceptive implant, contraceptive injection, pill, vaginal ring or male condoms. The first three methods are placed by a medical provider, the injection occurs at a medical office and the remaining options are user-controlled.<\/p>\n
\u201cPatients received their preferred method, had timely access, felt respected and could stop and switch methods at any time,\u201d says Jessica Sanders, a reproductive health researcher at University of Utah Health.<\/p>\n
The analysis included more than 4,000 participants, 82 percent of whom completed the full three years of follow-up. The research team kept track of how long people continued with their original method. The team also calculated the contraceptive failure rate, defined as a pregnancy despite using the original method in the four weeks prior. That came to 96 pregnancies.<\/p>\n
Over three years, there was around 1 pregnancy per 100 participants per year among users of all methods except male condoms. The variation was narrow overall, ranging from 0.7 per 100 per year for hormonal IUD users to 1.6 per 100 per year for pill users. The estimated rate for condom users, 2.6 per 100, is limited by a small sample size.<\/p>\n
\u201cPeople should feel really valid in whatever decision they make,\u201d Sanders says. \u201cThese are all effective methods at preventing pregnancy.\u201d<\/p>\n
The greater parity among the effectiveness of different methods stands in contrast to a memorable statistic from a 2012 study. The Contraceptive CHOICE Project\u2019s stated goal was to promote the use of long-acting reversible contraceptives, according to the project team at Washington University School of Medicine in St. Louis. The study reported that participants using the contraceptive patch, the pill or the ring had a failure rate of 4.6 per 100 people per year, about 20 times higher<\/a> than that of implants or IUDs.<\/p>\n\u201cWhat HER Salt Lake adds is incredible evidence that having the ideal access and support to use [preferred] methods actually increases the effectiveness of shorter-term methods for preventing pregnancy,\u201d says Anu Manchikanti G\u00f3mez, a sexual and reproductive health equity researcher at the University of California, Berkeley, who was not involved in the study.<\/p>\n
That support and access can prevent lapses in consistent use. And it\u2019s not only about forgetting to take a pill. It can be hard for some to take time off from work to see a doctor. Others don\u2019t have transportation to get to the pharmacy. \u201cA missed refill, a delayed appointment, out-of-pocket costs or an unavailable method creates that gap \u2014 it\u2019s not necessarily on the person,\u201d Sanders says. \u201cThe small disruptions matter.\u201d<\/p>\n
The study also adds to the evidence behind respecting patient preferences in choosing a birth control method. Person-centered contraceptive counseling focuses on the values and priorities of the patient. Those could include effectiveness, avoiding side effects or being able to start and stop a method at home rather than depend on a medical visit. Often, health care providers have thought primarily in terms of effectiveness, recommending long-acting methods instead of prioritizing patients\u2019 preferences.<\/p>\n
White starts conversations about contraception by asking, \u201cWhat is important to you about your birth control?\u201d and leaves it open-ended to let the patient be the guide. \u201cWhen people feel heard,\u201d she says, \u201cthey are more likely to have trust in the care they are getting [and] to reach back out if they have any problems.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
New research shakes up the premise that implants and other long-acting contraception methods are far and away the most effective choice. The HER Salt Lake Contraceptive Initiative first provided participants with contraceptive counseling that focused on their needs and values. Then, the initiative got them started on their chosen method right away and provided refills […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[10],"tags":[],"_links":{"self":[{"href":"https:\/\/www.adviews.info\/news\/index.php?rest_route=\/wp\/v2\/posts\/105340"}],"collection":[{"href":"https:\/\/www.adviews.info\/news\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.adviews.info\/news\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.adviews.info\/news\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.adviews.info\/news\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=105340"}],"version-history":[{"count":0,"href":"https:\/\/www.adviews.info\/news\/index.php?rest_route=\/wp\/v2\/posts\/105340\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.adviews.info\/news\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=105340"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.adviews.info\/news\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=105340"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.adviews.info\/news\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=105340"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}