title: Self-administration of subcutaneous depot medroxyprogesterone acetate by adolescent women.
abstract: BACKGROUND
  Intramuscular depot medroxyprogesterone acetate (DMPA-IM) is now available in subcutaneous (SC) formulation, potentially allowing for home-based self-administration. We examined adolescents' interest in and proficiency at DMPA-SC self-administration.
  
  
  METHODS
  This is a planned secondary analysis of a randomized controlled trial comparing pain between DMPA-IM and DMPA-SC. In the trial, study participants (N=55) aged 14-21 years were recruited at DMPA initiation and randomized to receive DMPA-IM or DMPA-SC. Participants received the alternate formulation at 3 months, chose formulation at 6 months and could learn self-administration at 9 months. The current analysis is of the women who chose self-administration of DMPA-SC. Proficiency was rated for each step of self-administration: independently [I], with reassurance [R], with verbal instruction [V] or nurse performed [RN]. Data were analyzed using descriptive and comparative statistics.
  
  
  RESULTS
  Thirty-five percent (19/55) of participants learned self-administration. Proficiency ratings were as follows: chose injection site (I=78.9%, R=5.3%, V=5.3%, RN=10.5%), cleaned site (I=89.5%, RN=10.5%), assembled injection device (I=47.4%, R=36.8%, V=15.8%), self-injected (I=31.6%, R=36.8%, V=15.8%, RN=15.8%) and disposed of device (I=21.1%, R=21.1%, RN=57.9%).
  
  
  CONCLUSIONS
  Many adolescents are interested in and capable of DMPA-SC self-administration with brief education and minimal assistance.
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA. rw6@iupui.edu
authors.forename: Rebekah L
authors.initials: RL
authors.lastname: Williams
authors.forename: Devon J
authors.initials: DJ
authors.lastname: Hensel
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
mesh_terms: D000293:Adolescent; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003692:Delayed-Action Preparations / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous / Q000379:methods; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D010146:Pain; D017060:Patient Satisfaction; D012646:Self Administration / Q000379:methods; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate
keywords: Adolescent; Contraception; Depot medroxyprogesterone acetate; Self-injection