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Twenty-four-month continuation of reversible contraception.
Obstet Gynecol 2013; 122(5):1083-91OG

Abstract

OBJECTIVE

To estimate 24-month continuation rates of all reversible contraceptive methods for women enrolled in the Contraceptive CHOICE Project.

METHODS

We analyzed 24-month data from the 9,256 participants enrolled in the Contraceptive CHOICE Project, a prospective observational cohort study that provides no-cost contraception to women in the St. Louis region. The project promoted the use of long-acting reversible contraception (LARC) (intrauterine devices [IUDs] and implants) in an effort to reduce the rates of unintended pregnancy. This analysis includes participants who received their baseline contraceptive method within 3 months of enrollment and who completed a 24-month follow-up survey (N=6,153).

RESULTS

Twenty-four month continuation rates for long-acting reversible contraception and non-LARC methods were 77% and 41%, respectively. Continuation rates for the levonorgestrel and the copper IUDs were similar (79% compared with 77%), whereas the implant continuation rate was significantly lower (69%, P<.001) compared with IUDs at 24 months. There was no statistically significant difference in 24-month continuation rates among the four non-LARC methods (oral contraceptive pill [OCP] 43%, patch 40%, ring 41%, depot medroxyprogesterone acetate [DMPA] 38%; P=.72). Participants who chose a LARC method at enrollment were at significantly lower risk of contraceptive method discontinuation (adjusted hazard ratio 0.29, 95% confidence interval 0.26-0.32) compared with women who selected a non-LARC method.

CONCLUSION

Intrauterine devices and the implant have the highest rates of continuation at 24 months. Given their effectiveness and high continuation rates, IUDs and implants should be first-line contraceptive options and shorter-acting methods such as OCPs, patch, ring, and DMPA should be second tier.

LEVEL OF EVIDENCE

II.

Authors+Show Affiliations

Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24104781

Citation

Oʼneil-Callahan, Micaela, et al. "Twenty-four-month Continuation of Reversible Contraception." Obstetrics and Gynecology, vol. 122, no. 5, 2013, pp. 1083-91.
Oʼneil-Callahan M, Peipert JF, Zhao Q, et al. Twenty-four-month continuation of reversible contraception. Obstet Gynecol. 2013;122(5):1083-91.
Oʼneil-Callahan, M., Peipert, J. F., Zhao, Q., Madden, T., & Secura, G. (2013). Twenty-four-month continuation of reversible contraception. Obstetrics and Gynecology, 122(5), pp. 1083-91. doi:10.1097/AOG.0b013e3182a91f45.
Oʼneil-Callahan M, et al. Twenty-four-month Continuation of Reversible Contraception. Obstet Gynecol. 2013;122(5):1083-91. PubMed PMID: 24104781.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Twenty-four-month continuation of reversible contraception. AU - Oʼneil-Callahan,Micaela, AU - Peipert,Jeffrey F, AU - Zhao,Qiuhong, AU - Madden,Tessa, AU - Secura,Gina, PY - 2013/10/10/entrez PY - 2013/10/10/pubmed PY - 2014/1/17/medline SP - 1083 EP - 91 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 122 IS - 5 N2 - OBJECTIVE: To estimate 24-month continuation rates of all reversible contraceptive methods for women enrolled in the Contraceptive CHOICE Project. METHODS: We analyzed 24-month data from the 9,256 participants enrolled in the Contraceptive CHOICE Project, a prospective observational cohort study that provides no-cost contraception to women in the St. Louis region. The project promoted the use of long-acting reversible contraception (LARC) (intrauterine devices [IUDs] and implants) in an effort to reduce the rates of unintended pregnancy. This analysis includes participants who received their baseline contraceptive method within 3 months of enrollment and who completed a 24-month follow-up survey (N=6,153). RESULTS: Twenty-four month continuation rates for long-acting reversible contraception and non-LARC methods were 77% and 41%, respectively. Continuation rates for the levonorgestrel and the copper IUDs were similar (79% compared with 77%), whereas the implant continuation rate was significantly lower (69%, P<.001) compared with IUDs at 24 months. There was no statistically significant difference in 24-month continuation rates among the four non-LARC methods (oral contraceptive pill [OCP] 43%, patch 40%, ring 41%, depot medroxyprogesterone acetate [DMPA] 38%; P=.72). Participants who chose a LARC method at enrollment were at significantly lower risk of contraceptive method discontinuation (adjusted hazard ratio 0.29, 95% confidence interval 0.26-0.32) compared with women who selected a non-LARC method. CONCLUSION: Intrauterine devices and the implant have the highest rates of continuation at 24 months. Given their effectiveness and high continuation rates, IUDs and implants should be first-line contraceptive options and shorter-acting methods such as OCPs, patch, ring, and DMPA should be second tier. LEVEL OF EVIDENCE: II. SN - 1873-233X UR - https://www.unboundmedicine.com/medline/citation/24104781/Twenty_four_month_continuation_of_reversible_contraception_ L2 - http://Insights.ovid.com/pubmed?pmid=24104781 DB - PRIME DP - Unbound Medicine ER -