Using telemedicine for contraceptive counseling

In response to the coronavirus disease 2019 pandemic, many U.S. family planning providers have started offering telemedicine services.

These providers find that telemedicine for contraceptive counseling during the early stage of the pandemic was a positive experience and believe that the service should be expanded, according to an exploratory survey in the journal Contraception.

First author Bianca Stifani, MD, a family planning fellow at Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, New York, and the other investigators were inspired to undertake the study based on their own experience with telemedicine at the height of the pandemic in New York City.

“We saw our own routines as physicians drastically changed by working from home,” Stifani told Contemporary OB/GYN®. “We also felt we were meeting many of our patients' needs efficiently.”

The authors wanted to find out if other family planning providers around the country were having similar experiences.

The cross-sectional, web-based survey was conducted in June and early July of 2020 and completed by 172 providers (34% response rate).

Overall, 91% of respondents offered telemedicine services in the 2 months prior to the survey, with 55.1% from a hospital/clinic and 42.9% from home. Most of these providers (78%) were new to telemedicine.

More than half of the cohort (54%) referred less than a quarter of their contraception patients for in-person visits. The most common in-person referral reason was long-acting reversible contraceptive (LARC) insertion (53%).

“We were surprised by the fact that many providers reported referring less than a quarter of patients for in-person visits,” Stifani said. “This could potentially mean that contraceptive counseling via telemedicine can meet many patients' needs; however, it would be important to see if these results are replicated outside the context of a pandemic, because patients may have made different contraceptive choices to avoid COVID-19 exposure.”

The survey also revealed that 80% of providers strongly agree that telemedicine visits are an effective way to provide contraceptive counseling and 84% believe this service should be expanded after the pandemic.

In addition, 64% of providers said they would be very happy if telemedicine were to become a routine part of their clinical practice after the pandemic.

Although almost half of providers used personal smartphones or laptops to conduct telemedicine visits, their ideal devices are work-issued computers, tablets or phones, and 60% prefer video over phone visits.

“We were surprised that many providers were using their personal computers or phones to conduct telemedicine visits, rather than work-issued devices,” Stifani said.

The study indicates that telemedicine may be an effective way to conduct contraceptive counseling and that it might meet many patient needs. “But it will be important to conduct more studies on telemedicine in normal times to assess the extent to which this technology can meet patients' needs outside of a pandemic,” Stifani said.

Also, technological challenges are one of the main obstacles to offering telemedicine. “Practices and hospitals should invest in telemedicine platforms that work and are easy to use for both patients and providers,” Stifani said.

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Disclosures

Stifani reports no relevant financial disclosures.

Source

Stifani BM, Avila K, Levi EE. Telemedicine for contraceptive counseling: an exploratory survey of US family planning providers following rapid adoption of services during the COVID-19 pandemic. Contraception. Published online November 17, 2020. doi:10.1016/j.contraception.2020.11.006