HealthDay News — Contraceptive counseling and provision interventions increase contraceptive use without increasing sexually transmitted infections or reducing condom use, according to a systematic review and meta-analysis published online May 24 in the Annals of Internal Medicine.
Heidi D. Nelson, M.D., M.P.H., from the Kaiser Permanente Bernard J. Tyson School of Medicine in Pasadena, California, and colleagues conducted a systematic review to examine evidence on the effectiveness of contraceptive counseling and provision interventions for women to increase use of contraceptives and reduce unintended pregnancy. Thirty-eight trials (43 articles with 25,472 participants) were included.
The researchers found that in multiple clinical settings, contraceptive use was higher with various counseling interventions, provision of emergency contraception in advance of use, and counseling or provision postpartum or at the time of abortion compared with usual care or active controls. With interventions, pregnancy rates were generally lower, but most trials were underpowered and did not distinguish pregnancy intention. There was no increased risk seen for sexually transmitted infections or reduction in condom use with interventions.
“Clinicians and health systems could improve contraceptive care by providing effective services applicable to their patient populations,” the authors write. “These include implementing enhanced contraceptive counseling, provision, and follow-up services; providing emergency contraception in advance; and delivering services immediately postpartum or at the time of abortion.”