that included all three LARC choices ( i . e ., LARC , IUD , and implantables ) and none of the other methods of birth control . Twenty-four ( 24 %) of participants correctly responded that LARC , IUD , and implantables are the recommended firstline methods of birth control , which is considered a perfect response . Fifty-five percent ( 55 %) included only LARC , IUD , or implantables in their response without including any of the alternative methods of birth control . Thus , the majority ( 55 %) of HCPs were correctly aware of the LARC recommendation . Six percent ( 6 %) of HCPs indicated they were unsure of what the ACOG / AAP recommendation was and did not select any of the available choices .
HCP BEHAVIOR : MOST COMMONLY PRESCRIBED METHODS OF CONTRACEPTION
Based on a confidence interval of 39.4 % to 61.8 %, HCPs are significantly more likely to prescribe combination oral contraceptives than any of the other three most commonly prescribed options , including the two LARC options — implantables and IUDs . The HCPs ’ birth control prescribing behavior did not differ by the HCP ’ s gender ( χ2 = 8.977 , df = 6 , p = 0.18 ).
HCP CONSISTENCY OF PRESCRIBING BEHAVIOR WITH KNOWLEDGE OF ACOG / AAP RECOMMENDATIONS
Due to the common belief that combination oral contraceptives and injectables are first-line recommendations ( Table 1 ) and the high frequency at which combination oral contraceptives were the most commonly prescribed method of birth control ( Table 2 ), we evaluated how many HCPs believed they were following the ACOG / AAP guidelines but in fact were not ( Table 3 ).
Table 3 shows that the majority of HCPs ( 59 %) who prescribe combination oral contraceptives and 42 % of the HPCs prescribing injectables mistakenly believed they were following the ACOG / AAP guidelines . The majority ( 85 %) of HCPs inserting IUDs correctly believed they were following first-line recommendations . On the other hand , 41 % of HCPs inserting implants believed implants were first-line recommendations . HCPs ’ beliefs and be-
TABLE 1 . First Line ACOG / AAP Recommendation Identification by HCP
HCP Indicated Methods as First line Birth Control *
95 % Confidence Interval **
CDC Reported Failure Rate 3
LARC 47.7 % 38.3 % to 57.1 % < 1 % IUD 34.9 % 26.0 % to 43.8 % < 1 % Pills 33.9 % 25.0 % to 42.8 % 9 % Implantable 30.3 % 21.7 % to 38.9 % < 1 % Injectable 30.3 % 21.7 % to 38.9 % 6 % Male Condom 23.9 % 15.9 % to 31.9 % 18 % Patch 16.5 % 9.5 % to 23.5 % 9 % Ring 16.5 % 9.5 % to 23.5 % 9 %
* CDC : Centers for Disease Control and Prevention ; ACOG : American College of Obstetricians and Gynecologists ; IUD : Intrauterine Device
* n = 84 , numbers do not add up to 100 % because respondents could provide more than one answer .
* Any birth control method that was identified by less than 10 % of the respondents was excluded from the table .
* Wider confidence intervals are associated with proportions near 50 % and smaller confidence intervals with proportions approaching 0 % or 100 %. Thus , the 95 % confidence interval surrounding the LARC estimate is approximately 14-18 percentage points wide .
TABLE 2 . Prescribing Behavior for Total HCP
Count * Percent ** 95 % Confidence Interval Oral Contraceptives 39 50.6 39.4 % to 61.8 % Implantable 17 22.1 12.8 % to 31.4 % IUD 7 9.1 2.7 % to 15.5 % Injectable 7 9.1 2.7 % to 15.5 %
* n = 77
** The table does not include contraceptive methods commonly prescribed by less than 9 % of HCPs .
TABLE 3 . HCP Behavioral Consistency with the ACOG / AAP Recommendations
Number who believe method is first line recommendation
Number who prescribe method most often
Percent who believe prescribing is consistent with recommendations
Pills 23 39 59 % Implantable 7 17 41 % IUD 6 7 85 %
Injectable 3 7 42 %
* HCP : Healthcare Providers ; ACOG : American College of Obstetricians and Gynecologists ; AAP : American Academy of Pediatrics ; IUD : Intrauterine Device
* n = 70 . Responses to both questions were required for analysis , thus sample sizes differ from previous tables .
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