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The Impact of Contraceptive Counseling in Primary Care on Contraceptive Use

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Journal of General Internal Medicine Aims and scope Submit manuscript

An Erratum to this article was published on 01 March 2011

ABSTRACT

BACKGROUND

Whether contraceptive counseling improves contraceptive use is unknown.

OBJECTIVE

To evaluate the association between contraceptive counseling provided by primary care physicians and patients’ contraceptive use.

DESIGN/PARTICIPANTS

All women aged 18–50 who visited one of four primary care clinics between October 2008 and April 2010 were invited to complete surveys about their visit. Seven to 30 days post visit, participants completed a survey assessing pregnancy intentions, receipt of contraceptive counseling, and use of contraception at last sexual intercourse. Survey data were linked to medical record data regarding contraceptive prescriptions prior to and during the clinic visit. Women were classified as in need of contraceptive counseling if they were sexually active, were not pregnant or trying to get pregnant, and had no evidence of contraceptive use prior to their index clinic visit.

KEY RESULTS

Fifty percent (n = 386) of women were in need of contraceptive counseling at the time of their visit. Those who received contraceptive counseling from a primary care provider were more likely to report use of hormonal contraception when they last had sex (unadjusted OR: 3.83, CI: 2.25–6.52), even after adjusting for age, race, education, income, marital status, pregnancy intentions, and prior pregnancy (adjusted OR: 2.68, CI: 1.48–4.87). Counseling regarding specific types of contraception was associated with an increased use of those methods. For example, counseling regarding hormonal contraceptives was associated with a greater likelihood of use of hormonal methods (adjusted OR: 4.78, CI: 2.51–9.12) and counseling regarding highly effective reversible methods was highly associated with use of those methods (adjusted OR: 18.45, CI: 4.88–69.84). These same relationships were observed for women with prior evidence of contraceptive use.

CONCLUSIONS

Contraceptive counseling in primary care settings is associated with increased hormonal contraceptive use at last intercourse. Increasing provision of contraceptive counseling in primary care may reduce unintended pregnancy.

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Acknowledgements

The data used in this analysis were collected with funding from AHRQ R18HS017093.

Dr. Eleanor Bimla Schwarz was funded by NICHD K23 HD051585.

Conflicts of Interest

None disclosed.

Author information

Authors and Affiliations

  1. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Jessica K. Lee SB, Aletha Y. Akers MD, MPH, Sonya Borrerro MD, MS & Eleanor Bimla Schwarz MD, MS

  2. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    Sara M. Parisi MS, MPH, Sonya Borrerro MD, MS & Eleanor Bimla Schwarz MD, MS

  3. Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA

    Eleanor Bimla Schwarz MD, MS

  4. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA, 15213, USA

    Aletha Y. Akers MD, MPH & Eleanor Bimla Schwarz MD, MS

Authors
  1. Jessica K. Lee SB
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  2. Sara M. Parisi MS, MPH
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  3. Aletha Y. Akers MD, MPH
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  4. Sonya Borrerro MD, MS
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  5. Eleanor Bimla Schwarz MD, MS
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Corresponding author

Correspondence to Eleanor Bimla Schwarz MD, MS.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s11606-011-1678-9

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Lee, J.K., Parisi, S.M., Akers, A.Y. et al. The Impact of Contraceptive Counseling in Primary Care on Contraceptive Use. J GEN INTERN MED 26, 731–736 (2011). https://doi.org/10.1007/s11606-011-1647-3

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  • DOI: https://doi.org/10.1007/s11606-011-1647-3

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