Evidence map›Paper›PMID 30076833›Full record

Observational studyContraception2018

Integration of contraceptive services into anticoagulation management services improves access to long-acting reversible contraception.

Caitlin Bernard, Chelsea Pekny, Christabell O Omukagah, Christian O Bernard, Imran Manji, Sonak D Pastakia, Astrid Christoffersen-Deb

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Contraception, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 10 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Caitlin BernardAMPATH/Indiana University, P.O. Box 4606, Eldoret, Kenya, 30100. Electronic address: caitlinbernardmd@gmail.com.
Chelsea PeknyAMPATH/Purdue University, P.O. Box 4606, Eldoret, Kenya, 30100. Electronic address: crpekny@gmail.com.
Christabell O OmukagahAMPATH, P.O. Box 4606, Eldoret, Kenya, 30100. Electronic address: tabellchrista@gmail.com.
Christian O BernardAMPATH, P.O. Box 4606, Eldoret, Kenya, 30100. Electronic address: christianoben@gmail.com.
Imran ManjiAMPATH/Moi Teaching & Referral Hospital, P.O. Box 4606, Eldoret, Kenya, 30100. Electronic address: imranmanji@hotmail.com.
Sonak D PastakiaAMPATH/Purdue University, P.O. Box 4606, Eldoret, Kenya, 30100. Electronic address: spastaki@gmail.com.
Astrid Christoffersen-DebAMPATH/University of Toronto, P.O. Box 4606, Eldoret, Kenya, 30100. Electronic address: astridcdeb@gmail.com.
AMPATH · KE

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
Washington University Institute of Clinical and Translational SciencesUL1TR000448 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$41.4M
WOMEN'S HEALTH AGENDAU01AI025903 · NIAID · WASHINGTON UNIVERSITY · PI CLIFFORD, DAVID B · 1987 to 2006
$12.5M
Washington University Institute of Clinical and Translational SciencesTL1TR000449 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$2.5M
Reproductive Epidemiology Training Program at Washington University in St. LouisT32HD055172 · NICHD · WASHINGTON UNIVERSITY · PI MADDEN, TESSA · 2009 to 2018
$2.5M
NCATS NIH HHS TL1 TR000449NCATS NIH HHS UL1 TR000448NCATS NIH HHS UL1 TR002345NIAID NIH HHS U01 AI025903NICHD NIH HHS T32 HD055172PEPFAR
6 · The paper itself

Abstract

objectiveIntegration of services is a promising way to improve access to contraception in sub-Saharan Africa, but few studies have evaluated this strategy to increase access to contraception among women requiring anticoagulation. Our objective was to evaluate a model of care integrating contraceptive counseling and provision within an anticoagulation management clinic in Eldoret, Kenya, to determine the impact on long-acting reversible contraception (LARC) use. STUDY

designWe performed a prospective observational study of reproductive-age women referred for integrated services from the anticoagulation management clinic at Moi Teaching and Referral Hospital from March 2015 to March 2016. All participants received disease-specific contraceptive counseling and provision, free reversible methods (excluding hormonal intrauterine devices [IUDs]) and follow-up care. We compared LARC use 3 months postintervention to preintervention using the proportions test. Logistic regression analysis was used to determine factors related to use of contraceptive implants and copper IUDs.

resultsOf 190 participants, 171 (90%) completed 3-month follow-up. There was a significant increase in contraceptive implant use from 10% to 19%, p=.02, and injectable contraceptive use from 14% to 24%, p=.013. There was a concomitant decrease in the use of no method/abstinence from 57% to 39% (33% decrease, p<.001). Younger age, having at least one child and discussing family planning with a partner were predictive of LARC use.

conclusionIntegrating contraceptive services into an anticoagulation management clinic increases the use of highly effective contraception for women with cardiovascular disease. Implementation of similar models of care should be evaluated within other sites for chronic disease management. IMPLICATIONS: A model of care integrating contraceptive counseling and provision into anticoagulation management services is an effective strategy to improve LARC and overall highly effective contraceptive use among women with cardiovascular disease requiring anticoagulation. This model of care may be utilized to prevent maternal morbidity and mortality among this high-risk population.

Indexed as

Health Services AccessibilityLong-Acting Reversible ContraceptionAdolescentAdultAnticoagulantsContraceptive Agents, FemaleDelivery of Health CareDrug ImplantsFamily Planning ServicesFemaleHumansIntrauterine Devices, CopperKenyaLogistic ModelsMiddle AgedOutpatient Clinics, HospitalAnticoagulantsContraceptive Agents, FemaleDrug ImplantsWarfarinCardiovascular diseaseChronic diseaseContraceptionFamily planningIntegration of careLARC

Identifiers

PMID30076833
PMCPMC6941485
OpenAlexW2885839633

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.