Continuation and satisfaction of reversible contraception.
Continuation and satisfaction of reversible contraception.
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DOI：
10.1097/aog.0b013e31821188ad
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发表时间：
2011-05
影响因子：
7.2
通讯作者：
Secura G
中科院分区：
文献类型：
--
作者：
Peipert JF;Zhao Q;Allsworth JE;Petrosky E;Madden T;Eisenberg D;Secura G
评估参加避孕选择项目的宫内节育器 (IUD) 和植入物使用者的 12 个月满意度和继续使用率，并将这些指标与使用口服避孕药 (OCP) 的女性进行比较。我们分析了参与一项前瞻性队列研究的前 5,087 名参与者的 12 个月数据，该研究对圣路易斯地区的女性提供了 3 年免费避孕措施。 CHOICE 的主要目的是促进长效可逆避孕（宫内节育器和植入物）的使用，并减少我们地区的意外怀孕。该分析包括在入组后 3 个月内接受基线避孕方法并达到 12 个月随访电话调查时间点的参与者 (N=4,167)。 68% 的参与者选择长效可逆避孕方法（45% 左炔诺孕酮宫内节育系统、10% 铜宫内节育器和 13% 皮下埋植剂），23% 选择联合激素方法（11% OCP、10% 阴道环和 2% 透皮贴剂），8% 选择长效醋酸甲羟孕酮。长效可逆避孕药使用者的 12 个月持续率 (86%) 高于 OCP 使用者 (55%)。两种宫内节育器的 12 个月持续使用率最高：左炔诺孕酮宫内节育系统 (88%) 和含铜宫内节育器 (84%)。使用植入物的女性在 1 年时的继续使用率也非常高 (83%)。满意度反映了持续性：超过 80% 的用户对宫内节育器感到满意，而对 OCP 的满意度为 54%。宫内节育器和皮下植入物的满意度和持续 12 个月的满意度最高。鉴于长效可逆避孕方法的避孕效果最高，应成为向患者提供的一线避孕方法。
To estimate 12-month satisfaction and continuation rates of intrauterine device (IUD) and implant users enrolled in the Contraceptive CHOICE Project and compare these measures to women using the oral contraceptive pills (OCPs). We analyzed 12-month data from the first 5,087 participants enrolled in a prospective cohort study of women in the St. Louis region offered contraception at no cost for 3 years. The primary purpose of CHOICE is to promote the use of long-acting reversible contraception (IUDs and implants) and to reduce unintended pregnancies in our region. This analysis includes participants who received their baseline contraceptive method within 3 months of enrollment and who reached the 12-month follow-up phone survey time point (N=4,167). Sixty-eight percent of our participants chose a long-acting reversible contraception method (45% levonorgestrel intrauterine system, 10% copper IUD, and 13% subdermal implant), while 23% chose combined hormonal methods (11% OCPs, 10% vaginal ring, and 2% transdermal patch), and 8% chose depot medroxyprogesterone acetate. Long-acting reversible contraception users had higher 12-month continuation rates (86%) than OCP users (55%). The two IUDs had the highest 12-month continuation rates: levonorgestrel intrauterine system (88%) and copper IUD (84%). Women using the implant also had very high rates of continuation at 1 year (83%). Satisfaction mirrored continuation: over 80% of users were satisfied with the IUD compared to 54% satisfied with OCPs. IUDs and the subdermal implant have the highest rates of satisfaction and 12-month continuation. Given that long-acting reversible contraception methods have the highest contraceptive efficacy, these methods should be the first-line contraceptive methods offered to patients.