Original article
Vol. 147 No. 3940 (2017)
Adolescents’ contraception continuation in Switzerland: a prospective observational study
- Cécile Diserens
- Adeline Quach
- Patrice Mathevet
- Pierluigi Ballabeni
- Martine Jacot-Guillarmod
Summary
BACKGROUND
Securing the adherence over time to contraception by adolescent girls is a challenge. Until now little was known about this topic in Switzerland. The aim of our study was to determine contraceptive continuation rates among adolescents in this country and assess possible predictive factors for discontinuation.
METHODS
A prospective observational cohort study of 12- to 19-year-old girls starting contraception was performed. Patients were interviewed again after 1 year by phone, email or postal mail.
RESULTS
A total of 204 patients were included, of whom 85.8% chose a combined oestrogen-progestogen pill. The answer rate 1 year later was 71%. Among these, continuation of the initially prescribed contraceptive method was observed in 73.1%. Factors statistically affecting the continuation rate were the initial contraceptive method, the place of residence and sexual activity after 1 year. Classification of contraceptive methods in decreasing order of continuation rate was the following: long acting reversible contraception (LARC) methods, oestrogen-progestogen pills, injections, progestogen pills, patches and rings. Major reasons reported for stopping the prescribed contraceptive method were ending sexual relations (54.3%), developing side effects (34.3%) or changing to another contraceptive method (22.9%). Neither age, nationality, smoking, occupation, nor the legal representative’s knowledge of the contraception influenced adherence.
CONCLUSION
Contraceptive continuation rate was high among the adolescent population studied. The only predictive factor of discontinuation was the contraceptive method. Our study also reveals that respecting teenagers’ confidentiality is essential as it does not negatively impact the continuation rate. The significant impact of the type of contraception on continuation rates stresses the importance of individualised counselling.
References
- Raine TR, Foster-Rosales A, Upadhyay UD, Boyer CB, Brown BA, Sokoloff A, et al. One-year contraceptive continuation and pregnancy in adolescent girls and women initiating hormonal contraceptives. Obstet Gynecol. 2011;117(2 Pt 1):363–71. doi:.https://doi.org/10.1097/AOG.0b013e31820563d3
- Rahman M, Berenson AB, Herrera SR. Perceived susceptibility to pregnancy and its association with safer sex, contraceptive adherence and subsequent pregnancy among adolescent and young adult women. Contraception. 2013;87(4):437–42. doi:.https://doi.org/10.1016/j.contraception.2012.09.009
- Bitzer J, Abalos V, Apter D, Martin R, Black A ; Global CARE (Contraception: Access, Resources, Education) Group. Targeting factors for change: contraceptive counselling and care of female adolescents. Eur J Contracept Reprod Health Care. 2016;21(6):417–30. doi:.https://doi.org/10.1080/13625187.2016.1237629
- Dehlendorf C, Grumbach K, Schmittdiel J, Steinauer J. Shared decision making in contraceptive counselling. Contraception. 2017;95(5):452–5. doi:.https://doi.org/10.1016/j.contraception.2016.12.010
- Carter WB, Inui TS, Kukull WA, Haigh VH. Outcome-based doctor-patient interaction analysis: II. Identifying effective provider and patient behavior. Med Care. 1982;20(6):550–66. doi:.https://doi.org/10.1097/00005650-198206000-00002
- Adherence strategies. Improve bedside manner, affect patient adherence. Communication makes a difference. Aids Alert. 2005;20(5):57–9.
- Merki-Feld GS, Gruber IM. Intention to use a combined contraceptive method and decision after counselling in Switzerland--Swiss data from the European CHOICE study. Eur J Contracept Reprod Health Care. 2012;17(2):119–27. Published online December 27, 2011. doi:.https://doi.org/10.3109/13625187.2011.630114
- Office fédéral de la Statistique [Internet] – Interruptions de grossesse[cited 2016 sept 19] - Available from http://www.bfs.admin.ch/bfs/portal/fr/index/themen/14/02/03/key/03.html and http://www.svss-uspda.ch/fr/suisse/adolescentes.htm
- Rosenstock JR, Peipert JF, Madden T, Zhao Q, Secura GM. Continuation of reversible contraception in teenagers and young women. Obstet Gynecol. 2012;120(6):1298–305. doi:.https://doi.org/10.1097/AOG.0b013e31827499bd
- Yoost JL, Hertweck SP, Barnett SN. The effect of an educational approach to pregnancy prevention among high-risk early and late adolescents. J Adolesc Health. 2014;55(2):222–7. Published online March 18, 2014. doi:.https://doi.org/10.1016/j.jadohealth.2014.01.017
- Alton TM, Brock GN, Yang D, Wilking DA, Hertweck SP, Loveless MB. Retrospective review of intrauterine device in adolescent and young women. J Pediatr Adolesc Gynecol. 2012;25(3):195–200. doi:.https://doi.org/10.1016/j.jpag.2012.01.005
- Dempsey AR, Johnson SS, Westhoff CL. Predicting oral contraceptive continuation using the transtheoretical model of health behavior change. Perspect Sex Reprod Health. 2011;43(1):23–9. Published online December 22, 2010. doi:.https://doi.org/10.1363/4302311
- Sucato GS, Land SR, Murray PJ, Cecchini R, Gold MA. Adolescents’ experiences using the contraceptive patch versus pills. J Pediatr Adolesc Gynecol. 2011;24(4):197–203. Published online March 30, 2011. doi:.https://doi.org/10.1016/j.jpag.2011.02.001
- Lete I, Pérez-Campos E, Correa M, Robledo J, de la Viuda E, Martínez T, et al. Continuation rate of combined hormonal contraception: a prospective multicenter study. J Womens Health (Larchmt). 2012;21(5):490–5. Published online October 26, 2011. doi:.https://doi.org/10.1089/jwh.2011.2967
- Suhonen S, Haukkamaa M, Jakobsson T, Rauramo I. Clinical performance of a levonorgestrel-releasing intrauterine system and oral contraceptives in young nulliparous women: a comparative study. Contraception. 2004;69(5):407–12. doi:.https://doi.org/10.1016/j.contraception.2003.11.008
- Berenson AB, Tan A, Hirth JM, Wilkinson GS. Complications and continuation of intrauterine device use among commercially insured teenagers. Obstet Gynecol. 2013;121(5):951–8. doi:.https://doi.org/10.1097/AOG.0b013e31828b63a0
- Westhoff C, Jones K, Robilotto C, Heartwell S, Edwards S, Zieman M, et al. Smoking and oral contraceptive continuation. Contraception. 2009;79(5):375–8. doi:.https://doi.org/10.1016/j.contraception.2008.12.003
- Alton TM, Brock GN, Yang D, Wilking DA, Hertweck SP, Loveless MB. Retrospective review of intrauterine device in adolescent and young women. J Pediatr Adolesc Gynecol. 2012;25(3):195–200. doi:.https://doi.org/10.1016/j.jpag.2012.01.005
- Lim SW, Rieder J, Coupey SM, Bijur PE. Depot medroxyprogesterone acetate use in inner-city, minority adolescents: continuation rates and characteristics of long-term users. Arch Pediatr Adolesc Med. 1999;153(10):1068–72. doi:.https://doi.org/10.1001/archpedi.153.10.1068
- Berenson AB, Wiemann CM, Rickerr VI, McCombs SL. Contraceptive outcomes among adolescents prescribed Norplant implants versus oral contraceptives after one year of use. Am J Obstet Gynecol. 1997;176(3):586–92. doi:.https://doi.org/10.1016/S0002-9378(97)70552-0
- Zibners A, Cromer BA, Hayes J. Comparison of continuation rates for hormonal contraception among adolescents. J Pediatr Adolesc Gynecol. 1999;12(2):90–4. doi:.https://doi.org/10.1016/S1083-3188(00)86633-4
- Castaño PM, Bynum JY, Andrés R, Lara M, Westhoff C. Effect of daily text messages on oral contraceptive continuation: a randomized controlled trial. Obstet Gynecol. 2012;119(1):14–20. doi:.https://doi.org/10.1097/AOG.0b013e31823d4167
- Maslyanskaya S, Coupey S, Chhabra R, Khan UI. Predictors of early discontinuation of effective contraception by teens at High risk of pregnancy. J Pediatr Adolesc Gynecol. 2016;29(3):269–75.
- Peipert JF, Zhao Q, Allsworth JE, Petrosky E, Madden T, Eisenberg D, et al. Continuation and satisfaction of reversible contraception. Obstet Gynecol. 2011;117(5):1105–13. doi:.https://doi.org/10.1097/AOG.0b013e31821188ad
- Committee on adolescent health care long acting reversible contraception working group, The American College of Obstetricians and Gynecologists ; Committee on Adolescent Health Care Long-Acting Reversible Contraception Working Group, The American College of Obstetricians and Gynecologists. Committee opinion no. 539: adolescents and long-acting reversible contraception: implants and intrauterine devices. Obstet Gynecol. 2012;120(4):983–8. doi:.https://doi.org/10.1097/AOG.0b013e3182723b7d
- Diedrich JT, Klein DA, Peipert JF. Long-Acting Reversible Contraception in Adolescents: A systematic Review and Meta-analysis. Am J Obstet Gynecol. Am J Obstet Gynecol. 2017;216(4):364.e1–12.
- Patseadou M, Michala L. Usage of the levonorgestrel-releasing intrauterine system (LNG-IUS) in adolescence: what is the evidence so far? Arch Gynecol Obstet. 2017;295(3):529–41. doi:.https://doi.org/10.1007/s00404-016-4261-0
- Usinger KM, Gola SB, Weis M, Smaldone A. Intrauterine Contraception Continuation in Adolescents and Young Women: A Systematic Review. J Pediatr Adolesc Gynecol. 2016;29(6):659–67. Published online July 4, 2016. doi:.https://doi.org/10.1016/j.jpag.2016.06.007