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Increasing uptake o...
Increasing uptake of long-acting reversible contraception with structured contraceptive counselling : cluster randomised controlled trial (the LOWE trial).
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- Emtell Iwarsson, Karin (författare)
- Karolinska Institutet
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- Envall, Niklas, 1984- (författare)
- Högskolan Dalarna,Sexuell, reproduktiv och perinatal hälsa,Sexuell, reproduktiv och perinatal hälsa,Karolinska Institutet, Stockholm
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- Bizjak, Isabella (författare)
- Karolinska Institutet
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Bring, Johan (författare)
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- Kopp Kallner, Helena (författare)
- Karolinska Institutet
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- Gemzell Danielsson, Kristina (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2021-06-07
- 2021
- Engelska.
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 128:9, s. 1546-1554
- Relaterad länk:
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https://doi.org/10.1...
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https://onlinelibrar...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- OBJECTIVES: To evaluate the effect of structured contraceptive counselling on uptake of long-acting reversible contraceptives (LARCs), and pregnancy rates.DESIGN: Cluster randomised trial SETTING: Abortion, youth, and maternal health clinics in Stockholm, Sweden.POPULATION: Sexually active women ≥18 years without a wish for pregnancy seeking abortion and/or contraceptive counselling.METHODS: For participants in clinics randomised to intervention, trained health care providers implemented a study-specific intervention package designed for structured contraceptive counselling. Participants in the control clinics received routine counselling.MAIN OUTCOME MEASURES: Primary outcome was choice of LARCs at first visit. Secondary outcomes were LARC initiation at three months and pregnancy rates at three and 12 months. We used logistic mixed-effects models with random intercept for clinic to account for clustering.RESULTS: From September 2017 to May 2019, 28 randomised clinics enrolled 1364 participants. Analyses including 1338 subjects showed that more participants in the intervention compared to control group chose LARCs (267/658 (40.6%) versus 206/680 (30.3%), odds ratio (OR) 2.77, 95% CI 1.99 to 3.86). LARC initiation was higher in the intervention compared to the control group (213/528 (40.3%) versus 153/531 (28.8%), OR 1.74, 95% CI 1.22 to 2.49). At abortion clinics, pregnancy rate was significantly lower at 12 months in the intervention versus the control group (13/101 (12.9%) versus 28/103 (27.2%), OR 0.39, 95% CI 0.18 to 0.88).CONCLUSIONS: Structured contraceptive counselling increased LARC uptake in all clinics and significantly reduced unintended pregnancy rates in abortion clinics at 12 months follow-up.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- LARC
- contraception
- counselling
- unintended pregnancy
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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