Counselling styles and their effect on subdermal contraceptive implant continuation rates

Abstract

Objectives This study compares whether counselling style prior to insertion of subdermal implants (SDIs) affects continuation rates at one-year post-insertion. Two senior doctors in a North London Integrated Sexual Health Clinic counselled patients in different ways.

Method This was a study involving 50 patients. Of these 25 received ‘cautious' counselling: they were advised to think carefully about having a SDI inserted and the counsellor emphasised the risks and relative inconvenience of inserting and removing the implant. The second group of 25 women received ‘just-try-it’ counselling; this consisted of encouraging the patients to have a SDI inserted and emphasising the reversibility of the method.

Results Continuation rates were 92% (23/25) for the ‘cautious' approach and 80% (20/25) for the ‘just-try-it’ approach. More SDI acceptors in the ‘just-try-it’ group (5/25) first learned about the existence of this contraceptive method during the same consultation in which the implant was inserted than in the ‘cautious' group (1/25). All six of these immediate acceptors kept their implant for at least a year.

Conclusion Continuation rates did not differ much between the two counselling styles and approaches were compatible with high continuation rates. Lowering the barriers to SDI use can benefit patients and reduce costs to the health economy.

Keywords:

• Subdermal implant
• Implanon®
• Continuation rates
• Counselling styles