title: Rationale and enrollment results for a partially randomized patient preference trial to compare continuation rates of short-acting and long-acting reversible contraception.
abstract: OBJECTIVE
  Most published contraceptive continuation rates have scientific limitations and cannot be compared; this is particularly true for dissimilar contraceptives. This study uses a new approach to determine if high continuation rates of long-acting reversible contraception (LARC) and protection from unintended pregnancy are observable in a population not self-selecting to use LARC.
  
  
  METHODS
  We are conducting a partially randomized patient preference trial (PRPPT) to compare continuation rates of short-acting reversible contraception (SARC) and LARC. Only women seeking SARC were invited to participate. Participants chose to be in the preference cohort (self-selected method use) or opted to be randomized to SARC or LARC; only those in the randomized cohort received free product. We compared participant characteristics, reasons for not trying LARC previously and the contraceptive choices that were made.
  
  
  RESULTS
  We enrolled 917 eligible women; 57% chose to be in the preference cohort and 43% opted for the randomized trial. The preference and randomized cohorts were similar on most factors. However, the randomized cohort was more likely than the preference cohort to be uninsured (48% versus 36%, respectively) and to cite cost as a reason for not trying LARC previously (50% versus 10%) (p<.01 for both comparisons). In the preference cohort, fear of pain/injury/side effects/health risks were the predominant reasons (cited by over 25%) for not trying LARC previously (p<.01 in comparison to randomized cohort).
  
  
  CONCLUSIONS
  Enrollment was successful and the process created different cohorts to compare contraceptive continuation rates and unintended pregnancy in this ongoing trial. The choices participants made were associated with numerous factors; lack of insurance was associated with participation in the randomized trial.
  
  
  CONCLUSIONS
  This PRPPT will provide new estimates of contraceptive continuation rates, such that any benefits of LARC will be more easily attributable to the technology and not the user. Combined with measuring level of satisfaction with LARC, the results will help project the potential role and benefits of expanding voluntary use of LARC.
authors.affiliation: FHI 360, 359 Blackwell Street, Suite 200, Durham, NC 27701, USA. Electronic address: dhubacher@fhi360.org.
authors.forename: David
authors.initials: D
authors.lastname: Hubacher
authors.affiliation: Planned Parenthood of Central North Carolina, PO Box 3258, Chapel Hill, NC 27515, USA.
authors.forename: Hannah
authors.initials: H
authors.lastname: Spector
authors.affiliation: Planned Parenthood of Central North Carolina, PO Box 3258, Chapel Hill, NC 27515, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Monteith
authors.affiliation: FHI 360, 359 Blackwell Street, Suite 200, Durham, NC 27701, USA.
authors.forename: Pai-Lien
authors.initials: PL
authors.lastname: Chen
authors.affiliation: FHI 360, 359 Blackwell Street, Suite 200, Durham, NC 27701, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Hart
mesh_terms: D000328:Adult; D003267:Contraception / Q000379:methods / Q000523:psychology*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D057240:Patient Preference / Q000523:psychology*; D018579:Patient Selection; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D055815:Young Adult
keywords: DMPA; IUD; LARC; Oral contraceptives; Subdermal contraceptive implant