Effect of a health education intervention on the demand for emergency contraception

Clemente Rodríguez C, Puente Palacios I, López Casanova MJ, Laso De La Vega I Artal S, Aranda Cárdenas D, Puiggalí Ballart M

Background and objective: Emergency contraception seeks to prevent pregnancy after

high-risk sexual intercourse. Although intended only for exceptional cases, there is evidence

that emergency contraception is being used often. This study aimed to evaluate an

educational intervention to reduce the percentage of reuse of emergency contraception.

Methods: Prospective comparative study carried out from October 2006 to October

2007. For all patients visiting our primary care emergency clinic asking for emergency

contraception, we recorded age, number of such requests made previously, and time

elapsed between requests. The women were informed about the effects of emergency

contraception, told that it was not an ideal method of regular contraception, and

instructed to see a gynecologist for evaluation of the results. We also asked permission to

telephone the women so they could respond to a survey questionnaire. The ji2 test was

used to compare data between groups; the effect of the intervention was assessed by

comparing the percentage of the intervention group reporting use of emergency

contraception previously to the percentage making new requests during the follow-up

period, so as to determine the reduction in absolute and relative risk.

Results: A total of 374 emergency contraception requests were processed. The mean

(SD) age was 24.5 (6.8) years; the rate of repeat requests in the first 6 months was

34.0%. Forty-seven women refused to participate; 115 agreed to participate but did not

respond to the survey. Of the 212 patients surveyed, 192 (90.6%) reported having

received information, 187 (88.2%) had read the brochure, 79 (37.3%) had seen a

gynecologist, and 19 (9%) asked for emergency contraception again within 6 months.

There was an absolute reduction of 25.0% in new requests for emergency contraception

(relative reduction, 73.5%).

Conclusions: This study shows that an educational intervention in emergency department

can reduce the use of this method of contraception.

Aranda Cárdenas D, Clemente Rodríguez C, Laso De La Vega I Artal S, López Casanova MJ, Puente Palacios I, Puiggalí Ballart M