When women are choosing a contraceptive, health care providers should be aware that the things they want to discuss may differ from what women want to hear, according to a survey published in the recent issue of the journal Contraception.
Most of the information women receive about contraceptives focuses heavily on the effectiveness in preventing pregnancy, but this information was ranked fifth in importance by women, according to the study conducted by researchers at Dartmouth College.
The researchers conducted an online survey of 417 women, aged 15-45, and 188 multidisciplinary contraceptive care providers in the United States. Both groups were asked what matters most when deciding on a contraceptive method, rating the importance of 34 questions.
The researchers found several differences. Women's number one question was about the safety of the contraceptive method, whereas for providers, it related to how the method is used.
Information about side effects was also more important to women than providers -- this was in the top three questions for 26 percent of women versus 16 percent of providers, the Dartmouth researchers said.
This first study to simultaneously explore the priorities of women and health care providers highlighted the importance of efforts to elicit each woman's preferences and values as part of a shared decision-making process.
"Everything we hear suggests that women are struggling to choose the contraceptive method that best fits their unique needs and preferences," said lead author of the study, Kyla Donnelly of The Dartmouth Institute for Health Policy & Clinical Practice. "Our findings suggest that this mismatch between what women want to know and what providers want to discuss may be a key factor."
Latest data suggest that in the United States, 51 percent of all pregnancies are unintended. There are more than 20 different methods of contraception available to women that vary substantially in their method of use, effectiveness, side effects and other features.
As a result of the Affordable Care Act, more women now than ever have access to a full range of contraceptive methods and counseling, free of out-of-pocket costs. The ACA also promotes shared decision-making and the use of decision support tools in health care.
In order for women and their health care providers to have better conversations about contraception, researchers at Dartmouth are developing brief tools, called Option Grids™ These tools are designed to help women and providers work together to compare available contraceptive methods on the things that matter most. The researchers conducted the survey in an effort to inform the content of the tools.
"Supporting women to choose the contraceptive method that fits their preferences and lifestyle is a critical part of providing patient-centered care and preventing unintended pregnancy," said co-author, Dr. Rachel Thompson from The Dartmouth Center for Health Care Delivery Science. "Given the current unprecedented access to contraception in the U.S., facilitating shared contraceptive decision-making in the clinical encounter is critical."
- Kyla Z. Donnelly, Tina C. Foster, Rachel Thompson. What matters most? The content and concordance of patients' and providers' information priorities for contraceptive decision making. Contraception, 2014; DOI: 10.1016/j.contraception.2014.04.012
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