Assessing Contraceptive Switching and Discontinuation Over 3 Years in the HER Salt Lake Study.

IF 5.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Obstetrics and gynecology Pub Date : 2024-07-01 Epub Date: 2024-05-23 DOI:10.1097/AOG.0000000000005621
Rebecca G Simmons, Gentry Carter, Jessica N Sanders, David K Turok
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引用次数: 0

Abstract

Objective: To assess contraceptive switching and discontinuation among participants enrolled in a contraceptive access project over 3 years and to identify variables associated with contraceptive change.

Methods: The HER Salt Lake study enrolled individuals between 2015 and 2017 from four clinics in Salt Lake County into a prospective, longitudinal cohort. All participants were able to switch or discontinue at no cost (between March 2016 and March 2020). We collected eight follow-up surveys over 3 years after enrollment. Each survey wave included questions about method use in the previous 4 weeks. We categorized participants in three ways, allowing for time-varying outcomes by wave: 1) those who reported using the same method as previous wave (continuers), 2) those who reported using a different method from previous wave (switchers), and 3) those who reported using no contraceptive method at that wave (discontinuers). We report the frequency of outcomes and conducted multinomial regression models assessing predictors of switching and discontinuation.

Results: Among 4,289 participants included in this analysis, 2,179 (50.8%) reported at least one instance of switching or discontinuation, and 2,110 (49.1%) reported continuing with their baseline method at the end of the study. Those reporting method change (switching or discontinuing) reported an average of 1.93 change events over the study follow-up period (range 1-8). Among those reporting any method change, 522 participants (23.9%) reporting at least one instance of both switching and discontinuation. Among those reporting any instance of discontinuation (n=966), 498 (51.6%) never reported uptake of a subsequent method. Among those who did report a subsequent method (n=468), 210 (44.8%) reported restarting a previously used method, and 258 (55.1%) reported starting a new method. Although we identified overlap among variables associated with switching and discontinuation, other predictors were discordant between switching and discontinuation.

Conclusion: New contraceptive users commonly switch and discontinue methods. User behavior is associated with certain demographic characteristics and pregnancy planning.

Clinical trial registration: ClinicalTrials.gov , NCT02734199.

评估 HER 盐湖研究中避孕药转换和停用 3 年的情况。
目的评估参加避孕药具普及项目的参与者在 3 年内的避孕药具转换和中止情况,并确定与避孕药具变化相关的变量:HER 盐湖研究在 2015 年至 2017 年期间从盐湖县的四家诊所招募人员,组成前瞻性纵向队列。所有参与者均可免费更换或停用避孕药具(2016 年 3 月至 2020 年 3 月)。在注册后的 3 年中,我们收集了 8 次跟踪调查。每次调查都包括有关前 4 周使用方法的问题。我们通过三种方式对参与者进行分类,并考虑到各次调查的时变结果:1)报告使用与上一次调查相同方法的人(继续使用者);2)报告使用与上一次调查不同方法的人(转换者);3)报告在该次调查中未使用任何避孕方法的人(停止使用者)。我们报告了结果发生的频率,并建立了多项式回归模型来评估转换和中止的预测因素:在参与分析的 4,289 名参与者中,2,179 人(50.8%)报告至少有一次更换或中止使用避孕方法,2,110 人(49.1%)报告在研究结束时继续使用其基准避孕方法。那些报告更换方法(更换或停止使用)的人在研究随访期间平均报告了 1.93 次更换方法事件(范围为 1-8)。在报告任何方法改变的参与者中,有 522 人(23.9%)报告至少有一次更换或停止使用方法。在报告任何一次停用的参与者(966 人)中,有 498 人(51.6%)从未报告过使用后续方法。在报告了后续使用方法的人群(人数=468)中,210 人(44.8%)报告重新开始使用以前使用过的方法,258 人(55.1%)报告开始使用新方法。尽管我们发现了与更换和中止相关的变量之间存在重叠,但其他预测因素在更换和中止之间并不一致:结论:新的避孕药具使用者通常会更换和停止使用避孕方法。用户行为与某些人口特征和怀孕计划有关:临床试验注册:ClinicalTrials.gov,NCT02734199。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Obstetrics and gynecology
Obstetrics and gynecology 医学-妇产科学
CiteScore
11.10
自引率
4.20%
发文量
867
审稿时长
1 months
期刊介绍: "Obstetrics & Gynecology," affectionately known as "The Green Journal," is the official publication of the American College of Obstetricians and Gynecologists (ACOG). Since its inception in 1953, the journal has been dedicated to advancing the clinical practice of obstetrics and gynecology, as well as related fields. The journal's mission is to promote excellence in these areas by publishing a diverse range of articles that cover translational and clinical topics. "Obstetrics & Gynecology" provides a platform for the dissemination of evidence-based research, clinical guidelines, and expert opinions that are essential for the continuous improvement of women's health care. The journal's content is designed to inform and educate obstetricians, gynecologists, and other healthcare professionals, ensuring that they stay abreast of the latest developments and best practices in their field.
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