In my day-to-day practice of counseling teens on birth control use, I often feel defeated. The information we impart to them is complex and confusing. It never surprises me to find that various methods have been used in all manor of ways (not to mention hair being washed with crushed oral contraceptives…but that’s another story). We invariably see teens who complain of abnormal vaginal bleeding, only to find that they have kept the ‘patch’ on for 3 weeks or that pills have been ‘tripled up’ due to missed ones.
In my day-to-day practice of counseling teens on birth control use, I often feel defeated. The information we impart to them is complex and confusing. It never surprises me to find that various methods have been used in all manor of ways (not to mention hair being washed with crushed oral contraceptives…but that’s another story). We invariably see teens who complain of abnormal vaginal bleeding, only to find that they have kept the ‘patch’ on for 3 weeks or that pills have been ‘tripled up’ due to missed ones.
Additionally, birth control is not adhered to because the initial choice of method was not right for that individual. Just last week a patient came in for a pregnancy test. In her medical chart it noted that she had been prescribed the pill as a method of birth control. She told me that she had started it but because she lives in between her Mom and Dad’s apartments, she forgets to take it back and forth. Added to that, neither parent was aware she was on birth control and she had it hidden at the bottom of a closet. The pill was clearly the wrong choice for this individual.
The up-take of birth control reminders via text message has proved to be highly popular amongst our adolescent population at MSAHC. This combined with extensive use of the ‘chat’ platform to clarify proper use of birth control has led to me designing a study using tailored text messages to support girls initiating a birth control method. It seems we need to find something to help these girls make the right choice and feel educated and supported in continuing it’s use. Perhaps technology can help us with this.
I was really interested in work presented by Allison Meserve MPH, Samantha Garbers MPA and Mary Ann Chiasson DrPH, on a self-administered computerized counseling module to improve contraceptive method choice. This large randomised controlled trial included 1,983 patients (adolescents and adults) and compared a ‘tailored counseling’ module, a ‘counseling’ module and a control. The tailored counseling module was found to significantly increase women’s choice of a more effective birth control method. A simple, yet effective strategy (http://bit.ly/pdUNQE).
As I take a walk through our ever crowded waiting area in the clinic, at least 95% of patients are looking at a handheld device. Many of these patients will be here for reproductive health. I can’t help but think that an ‘app’ with a birth control ‘module’ could be the answer to this on-going problem of poor up-take and adherence to birth contol use, or perhaps I’m being too naive and ‘angry birds’ will continue be the preferred option….