1. Most patients in a dermatology clinic had gaps in their baseline knowledge of contraceptive effectiveness and overestimated the typical effectiveness of condoms, oral contraceptives, and contraceptive injections.
2. After viewing an information sheet on effectiveness of various contraceptive options, patients significantly improved their contraceptive knowledge.
Evidence Rating Level: 2 (Good)
Study Rundown: Isotretinoin is used to treat severe acne that doesn’t respond to other treatments. While it is efficacious as a therapeutic, it can cause severe birth defects in those who conceive while on the medication. Implementation of programs, such as iPLEDGE, to curtail users against getting pregnant while taking the drug has had mediocre success. Previous studies have shown that a major barrier for women taking isotretinoin is that they lack information on effective contraception. These authors investigated whether giving dermatologic patients an information sheet on effectiveness of various contraception methods would increase their baseline knowledge. This study showed that briefly viewing a contraception information sheet improved knowledge and post-intervention quiz scores; however the study’s findings may not be applicable to all isotretinoin users as the cohort consisted of women patients at a general dermatology clinic.
Click to read the study in JAMA Dermatology
Relevant Reading: Women’s experiences with isotretinoin risk reduction counseling
In-Depth [cross-sectional study]: Women between 18 and 45 were recruited in the waiting room of an urban dermatology practice to participate in the study. Ultimately, 100 patients consented to participate. Key characteristics of this group included a mean age of 27.5 years, a majority of white participants (66%), and 66% of participants with a college education. Only 11 participants reported previously or currently having been treated with isotretinoin. Participants were given a pre- and post-intervention quiz regarding contraceptive effectiveness. Participants spent a mean of 31 seconds reviewing the contraception information sheet. The pre-intervention quiz revealed that participants overestimated the effectiveness of condoms, contraceptive injections and oral contraceptives by 75%, 57%, and 51%, respectively. Sixteen percent and 34% of the cohort had never heard of intrauterine devices and contraceptive implants, respectively. The post-intervention quiz revealed statistically significant increases in knowledge of almost all contraceptive types (subdermal implant, 45% to 78% [P < .001]; IUD, 61% to 83% [P < .001]; injection, 28% to 44% [P = .02]; ring, 60% to 69% [P = .18]; patch, 50% to 71% [P = .002]; pills, 41% to 65% [P < .001]; condoms, 25% to 45% [P = .003]; withdrawal, 74% to 90% [P = .003]).
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