Effectiveness of a Patient Decision Aid in Postpartum Contraceptive Counseling [1E]. (May 2018)

• Record Type: Journal Article
• Authors: Cha, Sandolsam; Levi, Erika; Findley, Molly; Leung, Wendy; Tarrash, Miriam; Benfield, Nerys
• Is Part Of: Obstetrics and gynecology. Volume 131(2018)Supplement 1
• Publication Date: 2018-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000533020.23138.bf
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Effective postpartum contraceptive counseling helps patients meet their reproductive life goals. Patient decision aids (PtDA) can facilitate counseling but the optimal structure and medium for a PtDA is unknown. METHODS: On postpartum day 1, women who had not received a postplacental LARC were randomized to: 1) a paper-based PtDA that featured contraceptive options for side-by-side comparison, 2) standard contraception brochure, or 3) website with comparison of contraceptive options. All patients received counseling utilizing their assigned tool. The concordance between a patient's decision and their values ("decision quality") and the extent to which she is clear about her values and feels informed ("decision-making process quality"), were evaluated using validated surveys. RESULTS: 126 patients were enrolled. The average age of participants was 28.9, half were Latina, 69% had public insurance, 42% were primiparous, and 60% had a vaginal delivery. There were no statistical differences among the groups except for counseling time (6.4 min for PtDA, 6.6 min for the website, and 4.9 min for the standard brochure, p=0.0152). The primary outcomes of "decision quality" and "decision-making process quality" were not statistically different. Regardless of the material, women found them helpful and would recommend to a friend. Although none of the materials highlighted LARC methods, half of all participants chose a LARC method. CONCLUSION: Women were satisfied with all approaches to postpartum contraception counseling in this study, which on average took only seven minutes. Our PtDA offer a low-tech solution that women find helpful. Further research is needed to determine its impact in the long-term.