Women's satisfaction with and ongoing use of hormonal long-acting methods compared to the oral contraceptive pill: Findings from an Australian general practice cluster randomised trial (ACCORd).

Black, KI; McGeechan, K; Watson, CJ; Lucke, J; Taft, A; McNamee, K; Haas, M; Peipert, JF; Mazza, D

Women's satisfaction with and ongoing use of hormonal long-acting methods compared to the oral contraceptive pill: Findings from an Australian general practice cluster randomised trial (ACCORd).

Black, KI McGeechan, K Watson, CJ Lucke, J Taft, A McNamee, K Haas, M

Peipert, JF Mazza, D

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: The Australian & New Zealand journal of obstetrics & gynaecology, 2021, 61, (3), pp. 448-453
Issue Date:: 2021-06

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Field	Value	Language
dc.contributor.author	Black, KI
dc.contributor.author	McGeechan, K
dc.contributor.author	Watson, CJ
dc.contributor.author	Lucke, J
dc.contributor.author	Taft, A
dc.contributor.author	McNamee, K
dc.contributor.author	Haas, M https://orcid.org/0000-0002-9726-3063
dc.contributor.author	Peipert, JF
dc.contributor.author	Mazza, D
dc.date.accessioned	2021-12-28T03:16:53Z
dc.date.available	2021-01-05
dc.date.available	2021-12-28T03:16:53Z
dc.date.issued	2021-06
dc.identifier.citation	The Australian & New Zealand journal of obstetrics & gynaecology, 2021, 61, (3), pp. 448-453
dc.identifier.issn	0004-8666
dc.identifier.issn	1479-828X
dc.identifier.uri	http://hdl.handle.net/10453/152545
dc.description.abstract	<h4>Background</h4>The Australian Contraceptive ChOice pRoject (ACCORd) aimed to assess the impact of a complex general practice intervention on the uptake of long-acting reversible contraceptives (LARC).<h4>Aims</h4>Using survey data from enrolled women, we aimed to compare the ongoing use and satisfaction of women who chose one of the hormonal LARC methods including the levonorgestrel intrauterine system (LNG-IUS) or levonorgestrel implant compared to the oral contraceptive pill (OCP).<h4>Materials and methods</h4>We used the data from participants' baseline, six and 12-month surveys to identify new users of implants, LNG-IUS or OCP. We included demographic information, ongoing use of the contraceptive method, reasons for dissatisfaction and discontinuation and experience of side-effects. Proportions were compared using χ<sup>2</sup> tests.<h4>Results</h4>Of the 740 women enrolled in ACCORd, 176 started using a hormonal LARC or OCP in the study's first six months with 76 using the IUS (43%), 60 the implant (34%) and 40 (23%) the OCP. Twelve-month continuation rates for the LNG-IUS, implant and OCP were 93, 83 and 65% respectively (P < 0.001). Satisfaction was highest among the LNG-IUS users; 86% were very/somewhat satisfied compared to 75% of implant users and 61% of OCP users (P < 0.001). Main reasons for method dissatisfaction were irregular bleeding and mood changes which were similar for all methods.<h4>Conclusions</h4>This study provides further evidence that hormonal LARC methods have higher continuation and satisfaction rates compared to the OCP with similar side-effects. Since hormonal LARC methods have the highest contraceptive efficacy, these should be offered first-line to women.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Wiley
dc.relation.ispartof	The Australian & New Zealand journal of obstetrics & gynaecology
dc.relation.isbasedon	10.1111/ajo.13319
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.mesh	Humans
dc.subject.mesh	Levonorgestrel
dc.subject.mesh	Contraceptive Agents, Female
dc.subject.mesh	Contraception
dc.subject.mesh	Intrauterine Devices, Medicated
dc.subject.mesh	Personal Satisfaction
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	General Practice
dc.subject.mesh	Australia
dc.subject.mesh	Contraception
dc.subject.mesh	Contraceptive Agents, Female
dc.subject.mesh	Female
dc.subject.mesh	General Practice
dc.subject.mesh	Humans
dc.subject.mesh	Intrauterine Devices, Medicated
dc.subject.mesh	Levonorgestrel
dc.subject.mesh	Personal Satisfaction
dc.title	Women's satisfaction with and ongoing use of hormonal long-acting methods compared to the oral contraceptive pill: Findings from an Australian general practice cluster randomised trial (ACCORd).
dc.type	Journal Article
utslib.citation.volume	61
utslib.location.activity	Australia
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access	*
dc.date.updated	2021-12-28T03:16:52Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	61
utslib.citation.issue	3

Abstract:

Background

The Australian Contraceptive ChOice pRoject (ACCORd) aimed to assess the impact of a complex general practice intervention on the uptake of long-acting reversible contraceptives (LARC).

Aims

Using survey data from enrolled women, we aimed to compare the ongoing use and satisfaction of women who chose one of the hormonal LARC methods including the levonorgestrel intrauterine system (LNG-IUS) or levonorgestrel implant compared to the oral contraceptive pill (OCP).

Materials and methods

We used the data from participants' baseline, six and 12-month surveys to identify new users of implants, LNG-IUS or OCP. We included demographic information, ongoing use of the contraceptive method, reasons for dissatisfaction and discontinuation and experience of side-effects. Proportions were compared using χ² tests.

Results

Of the 740 women enrolled in ACCORd, 176 started using a hormonal LARC or OCP in the study's first six months with 76 using the IUS (43%), 60 the implant (34%) and 40 (23%) the OCP. Twelve-month continuation rates for the LNG-IUS, implant and OCP were 93, 83 and 65% respectively (P < 0.001). Satisfaction was highest among the LNG-IUS users; 86% were very/somewhat satisfied compared to 75% of implant users and 61% of OCP users (P < 0.001). Main reasons for method dissatisfaction were irregular bleeding and mood changes which were similar for all methods.

Conclusions

This study provides further evidence that hormonal LARC methods have higher continuation and satisfaction rates compared to the OCP with similar side-effects. Since hormonal LARC methods have the highest contraceptive efficacy, these should be offered first-line to women.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/152545