title: Promoting safe use of isotretinoin by increasing contraceptive knowledge.
abstract: OBJECTIVE
  Isotretinoin, a known teratogen, is strictly regulated through the iPLEDGE program. However, isotretinoin-exposed pregnancies continue to occur.
  
  
  OBJECTIVE
  To evaluate an information sheet's effect on women's contraceptive knowledge.
  
  
  METHODS
  Women aged 18 to 45 years visiting a dermatology practice completed anonymous surveys assessing their knowledge of the typical effectiveness of 8 contraceptive methods before and after reviewing an educational information sheet. Participants categorized each contraceptive as "most effective, >99% effective," "medium effective, 92%-97% effective," or "least effective, <89% effective" or indicated that they had "never heard of" it. All participants were recruited from a single dermatology clinic between April and May 2014. A total of 118 women were approached by consecutive sampling, and surveys were completed by 100 women.
  
  
  METHODS
  Preintervention contraceptive effectiveness knowledge and change in contraceptive effectiveness knowledge after viewing the educational tool.
  
  
  RESULTS
  Prior to viewing the contraceptive information sheet, more than half of women overestimated the typical effectiveness of condoms (75%), contraceptive injections (57%), and oral contraceptives (51%). Thirty-four percent had never heard of contraceptive implants, whereas 16% had never heard of an intrauterine contraceptive device (IUD). Participants correctly identified the typical effectiveness of only a mean (SD) of 3.8 (1.9) of the 8 contraceptives that they were asked about. Only 3% of participating women were able to correctly identify the typical effectiveness of all available contraceptives. On average, women spent less than 1 minute reviewing the contraceptive information sheet (mean [SD], 31 [27] seconds). After viewing the educational handout, the proportions of participants able to correctly identify the typical effectiveness of contraceptives increased for almost all methods (subdermal implant, 45% to 78% [P < .001]; IUD, 61% to 83% [P < .001]; injection, 28% to 44% [P = .02]; ring, 60% to 69% [P = .18]; patch, 50% to 71% [P = .002]; pills, 41% to 65% [P < .001]; condoms, 25% to 45% [P = .003]; withdrawal, 74% to 90% [P = .003]).
  
  
  CONCLUSIONS
  A contraceptive information sheet can significantly improve patients' contraceptive knowledge and may be a useful addition to efforts to prevent isotretinoin-induced birth defects.
authors: School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania2Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Carly A
authors: CA
authors: Werner
authors: Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Melissa J
authors: MJ
authors: Papic
authors: School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania4Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors: Laura K
authors: LK
authors: Ferris
authors: School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania2Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania3Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsy.
authors: Eleanor B
authors: EB
authors: Schwarz
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods*; D003625:Data Collection; D003879:Dermatologic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015474:Isotretinoin / Q000009:adverse effects* / Q000627:therapeutic use; D010353:Patient Education as Topic / Q000379:methods*; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin