Impact of Structured Counseling on the Selection of Hormonal Contraceptive Methods: Results of a Multi-Centric,Observational Study in India |
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Authors: | Nozer Sheriar Ritu Joshi Basab Mukherjee Bhaskar Pal Ashish Birla Subrat K. Ray |
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Affiliation: | 1. Department of Obstetrics and Gynecology, Breach Candy Hospital, 60 A, Bhulabhai Desai Road, Mumbai, Maharashtra, 400026, India 2. Department of Obstetrics and Gynecology, Monilek Hospital and Research Center, Sector 4, Jawahar Nagar, Jaipur, Rajasthan, 302004, India 3. Department of Obstetrics and Gynecology, Calcutta Medical Research Institute, 7/2, Diamond Harbour Road, Alipore, Kolkata, West Bengal, 700027, India 4. Department of Obstetrics and Gynecology, Apollo Gleneagles Hospital, 58, Canal Circular Road, Kolkata, West Bengal, 700054, India 5. Department of Medical Affairs, Organon (India) Private Limited, A Subsidiary of Merck & Co. Inc.,Whitehouse Station, NJ, USA, Platina Building, 8th Floor, C-59, G-Block, Bandra Kurla Complex, Bandra (East), Mumbai, 400098, India
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Abstract: | Objective To determine the influence of “structured contraception counseling” on Indian women’s selection of contraceptive methods. Methods Women (≥18 and ≤40 years) requesting contraception were enrolled at 36 sites. “Structured contraception counseling” was provided by a health care professional on the available contraceptive methods. Questionnaires on the women’s pre- and post-counseling contraceptive choice, her perceptions, and the reasons behind her post-counseling decision were filled. Results Significant reductions were observed in the proportion of women who were indecisive (n = 260; 31.5 % pre-counseling vs. n = 30; 3.6 %, post-counseling [P < 0.001]) and women opting for non-hormonal method (24.6 % pre-counseling vs. 6.8 % post-counseling, [P < 0.001]). Of all the women counseled (n = 825), 89.6 % (739/825) of women chose a hormonal contraceptive method. There were significant difference (P < 0.001) in the women’s choice of contraceptive in the pre- and post-counseling sessions, respectively (combined oral contraceptive: 30.8 vs. 40.7 %; vaginal ring: 1.8 vs. 14.1 %; progestogen only pills: 1.6 vs. 7.9 %; injectable-depot medroxyprogesterone acetate: 5.9 vs. 13.6 %; levonorgestrel-intrauterine system: 3.8 vs. 13.3 %). Conclusions Structured contraception counseling using standardized protocol and aids resulted in a significant increase in the selection of modern contraceptive methods. Post-counseling majority of women opted for hormonal methods with an increase in selection of pills and newer alternatives. |
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Keywords: | Hormonal contraceptive Counseling Questionnaire India |
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