Contraception Decision-Making: What Are Women’s Priorities?

Rachel Thompson PhD Postdoctoral Research Fellow The Dartmouth Center for Health Care Delivery Science Dartmouth CollegeMedicalResearch.com: Interview with
Rachel Thompson PhD
Postdoctoral Research Fellow
The Dartmouth Center for Health Care Delivery Science
Dartmouth College


MedicalResearch: What are the main findings of the study?

Dr. Thompson: This study, which surveyed 417 women aged 15-45 years and 188 contraceptive care providers in 2013, found important differences in what matters most to these two groups when it comes to discussing and deciding on a contraceptive method. Women’s most important question when choosing a contraceptive was “Is it safe?” – this was in the top three questions for 42% of women but only 21% of providers. Alternatively, providers’ most important question was “How is it used?”. Information on side effects and how a method actually works to prevent pregnancy was also a higher priority for women than for providers.

MedicalResearch: Were any of the findings unexpected?

Dr. Thompson: One surprising finding was that women ranked a contraceptive method’s effectiveness at preventing pregnancy only fifth in importance for their decision-making, behind the safety of the method, how it works to prevent pregnancy, how it is used, and possible side effects. This suggests that the information we currently give women to help with their contraceptive decision-making, which typically focus heavily on effectiveness, should be expanded to incorporate other things that matter most to women.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Thompson: Ours is the first study to simultaneously explore the priorities of women and health care providers for contraceptive decision-making. It has shown that providers should be alert to the possibility of a mismatch between their priorities and women’s priorities when contraceptive methods are being discussed and chosen, and make efforts to ensure women receive the information they want and need. Equally, it highlights the importance of women asking questions and sharing what matters most to them when having conversations about contraception with a health care provider.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Thompson: Altogether, our study highlights the importance of shared decision-making, the process where patients and providers make health care decisions together based on quality information, clinical expertise, and patient preferences. Informed by the findings of our study, we are developing brief tools called Option GridsTM to help women and providers compare contraceptive methods together in a shared decision-making process. We anticipate that these tools will help each woman to choose the contraceptive method that best fits her preferences, values, and circumstances, and will help prevent unintended pregnancies. Given that in the United States, 51% of all pregnancies are unintended, understanding how we can support women and providers to have quality conversations about contraception is critical.

Citation:

What matters most? The content and concordance of patients’ and providers’ information priorities for contraceptive decision making

Kyla Z. Donnelly, Tina C. Foster, Rachel Thompson
Contraception – 01 May 2014 (10.1016/j.contraception.2014.04.012)