The CHOICE study : effect of counselling on the selection of combined hormonal contraceptive methods in 11 countries

ABSTRACT Objectives To encourage healthcare professionals to counsel women seeking combined hormonal contraceptives (CHCs) about alternative CHCs and to study the influence of counselling on women's selection of CHCs. Methods Women (15-40 years old) in 11 countries who consulted HCPs about CHCs were counselled about the pill, transdermal patch, and vaginal ring. Both the HCPs and the women completed questionnaires. Results Of women who were counselled (n = 18,787), 47% selected another CHC method than originally planned. One in four who intended to use the pill chose another method (16% chose the patch; 65% chose the ring). In total, patch use increased from 5% -8% (difference = 3.7% [97.5% CI: 3.3-4.2]; p > 0.0001). Ring use nearly quadrupled from 8% -30% (difference = 21.7% [97.5% CI: 21.0-22.5]; p > 0.0001). Nearly all women who were undecided prior to counselling selected a method after counselling. Selection of the pill increased most in Russia (+ 11%) and Sweden (+ 5%); patch selection was greatest in Russia (+ 7%) and Israel (+ 6%); ring use increased most in Ukraine and in the Czech Republic and Slovakia (+ 36%). Conclusions Counselling increases use of alternative CHCs, such as the patch and the ring. Considerable differences between countries were noted.