Factors influencing women's selection of combined hormonal contraceptive methods after counselling in 11 countries: Results from a subanalysis of the CHOICE study

Abstract

Objectives To investigate which characteristics of women and healthcare professionals (HCPs) were associated with changing to another combined hormonal contraceptive (CHC) method after contraceptive counselling.

Methods CHOICE was a cross-sectional survey in which 18,787 women were counselled about combined hormonal contraceptives, during which their contraceptive methods preferred both prior to and after counselling were recorded. In this subanalysis, characteristics associated with changing the method after counselling were determined using logistic regression models.

Results The probability of intending to change from the pill to another method was associated with being older; university-educated; being in a steady relationship; a prior unintended pregnancy; a younger HCP or one who recommended methods other than the pill. Changing to the patch was associated with a female HCP or a HCP who recommended the patch or an injectable. Changing to the ring was associated with being over 21 years; university-educated; being in a relationship; previous hormonal method use; and counselling by a female HCP, a HCP < 60 years old, or a HCP who recommended the ring or an implant. The country of residence influenced these changes in a complex pattern.

Conclusions Women's choice of CHC methods after contraceptive counselling are influenced by their age, educational background, relationship status, prior unplanned pregnancies and country of residence, as well as age, gender and preferences of their HCP.

Keywords:

• Combined hormonal contraception
• Combined oral contraceptive
• Transdermal contraceptive patch
• Vaginal contraceptive ring
• Counselling

ACKNOWLEDGEMENTS

The study was funded by Merck Sharp & Dome, a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. Medical writing and editorial assistance was provided by Peter Morello, PhD, and Fiona Nitsche, PhD, of Evidence Scientific Solutions. This assistance was funded by Merck & Co., Inc., Whitehouse Station, NJ, USA.

Declaration of interest: Dr Bitzer is president and Dr Gemzell-Danielsson is a board member of the ESC. Drs Bitzer, Gemzell-Danielsson, Cupanik, Fait, Pwelczyk and Uzeitig have served on medical advisory boards of Merck Sharp & Dome (MSD) and occasionally serve as ad hoc lecturers for MSD. They have also served as investigator, consultant, or lecturer for MSD and other manufacturers of contraceptives. Mr Grob and Dr Oddens are employees of MSD and may potentially own stock and/or hold stock options in the company.