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JAMA Dermatol. 2015 Apr;151(4):389-93. doi: 10.1001/jamadermatol.2014.4171.

Promoting safe use of isotretinoin by increasing contraceptive knowledge.

Author information

1
School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania2Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.
2
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
3
School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania4Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania.
4
School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania2Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania3Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsy.

Abstract

IMPORTANCE:

Isotretinoin, a known teratogen, is strictly regulated through the iPLEDGE program. However, isotretinoin-exposed pregnancies continue to occur.

OBJECTIVE:

To evaluate an information sheet's effect on women's contraceptive knowledge.

DESIGN, SETTING, AND PARTICIPANTS:

Women aged 18 to 45 years visiting a dermatology practice completed anonymous surveys assessing their knowledge of the typical effectiveness of 8 contraceptive methods before and after reviewing an educational information sheet. Participants categorized each contraceptive as "most effective, >99% effective," "medium effective, 92%-97% effective," or "least effective, <89% effective" or indicated that they had "never heard of" it. All participants were recruited from a single dermatology clinic between April and May 2014. A total of 118 women were approached by consecutive sampling, and surveys were completed by 100 women.

MAIN OUTCOMES AND MEASURES:

Preintervention contraceptive effectiveness knowledge and change in contraceptive effectiveness knowledge after viewing the educational tool.

RESULTS:

Prior to viewing the contraceptive information sheet, more than half of women overestimated the typical effectiveness of condoms (75%), contraceptive injections (57%), and oral contraceptives (51%). Thirty-four percent had never heard of contraceptive implants, whereas 16% had never heard of an intrauterine contraceptive device (IUD). Participants correctly identified the typical effectiveness of only a mean (SD) of 3.8 (1.9) of the 8 contraceptives that they were asked about. Only 3% of participating women were able to correctly identify the typical effectiveness of all available contraceptives. On average, women spent less than 1 minute reviewing the contraceptive information sheet (mean [SD], 31 [27] seconds). After viewing the educational handout, the proportions of participants able to correctly identify the typical effectiveness of contraceptives increased for almost all methods (subdermal implant, 45% to 78% [P < .001]; IUD, 61% to 83% [P < .001]; injection, 28% to 44% [P = .02]; ring, 60% to 69% [P = .18]; patch, 50% to 71% [P = .002]; pills, 41% to 65% [P < .001]; condoms, 25% to 45% [P = .003]; withdrawal, 74% to 90% [P = .003]).

CONCLUSIONS AND RELEVANCE:

A contraceptive information sheet can significantly improve patients' contraceptive knowledge and may be a useful addition to efforts to prevent isotretinoin-induced birth defects.

PMID:
25650743
DOI:
10.1001/jamadermatol.2014.4171
[Indexed for MEDLINE]

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