Observational, prospective, multicentre study to evaluate the effects of counselling on the choice of combined hormonal contraceptives in Italy--the ECOS (Educational COunselling effectS) study.
BACKGROUND
Adequate counselling on contraceptive methods can help users choose the most appropriate method. The aim of this study was to assess the effects of structured counselling provided by gynaecologists on selection of a combined hormonal contraception method.


METHODS
Women aged 18-40 years (n = 1871) who were considering the use of a combined hormonal contraception method (pill, transdermal patch or vaginal ring) underwent a structured counselling session in which gynaecologists provided comprehensive information. Pre- and post-counselling questionnaires on combined hormonal contraception choice were completed by participants.


RESULTS
After counselling, many women (38 %) selected a combined hormonal contraception method that was different from the originally intended one. Preferences for the transdermal patch approximately doubled (from 3.2 % pre-counselling to 7 %; p < 0.0001) and those for the vaginal ring increased four-fold (from 5.2 to 21.2 %; p < 0.0001), while preference for the pill remained unchanged (from 64.5 % [pre-] to 64.1 % [post-counselling]). The proportion of undecided women decreased from 18 to 2.1 % (p < 0.0001). The main reasons for choosing a method were related to ease of use (all methods), and preferences for administration frequency (daily, weekly or monthly). The number of patients requiring post-counselling contact with the physician's office was low (5.1-6.9 %), as was the incidence of adverse events (1.8-3.1 %).


CONCLUSIONS
Counselling has a significant impact on women's choice of combined hormonal contraception and encourages them to consider alternative methods to combined oral contraceptives. Moreover, it also enables women to use their chosen method with confidence.


BACKGROUND
NCT01181778 , Trial registration date: August 12, 2010.
Spedali Civili di Brescia, Clinica Universitaria, Brescia, Italy. alessandro.gambera@tin.it.
Alessandro
A
Gambera
Centro Donna c/o Ospedale Binaghi, Cagliari, Italy. fedelacorda@asl8cagliari.it.
Fedela
F
Corda
UOC Tutela Salute Donna- ASL Napoli 1 CENTRO, Naples, Italy. rosapapa@alice.it.
Rosetta
R
Papa
Policlinico Umberto I, Dipartimento di Ginecologia e Ostetricia, Rome, Italy. carlo.bastianelli@uniroma1.it.
Carlo
C
Bastianelli
Azienda Universitaria Careggi, Divisione Clinica Ostetrica, Florence, Italy. sandra.bucciantini@virgilio.it.
Sandra
S
Bucciantini
A.O.U. di Sassari Macrostruttura Materno Infantile Clinica Ostetrico Ginecologica, Sassari, Italy. dessole@uniss.it.
Salvatore
S
Dessole
Spedali Civili di Brescia, Clinica Universitaria, Brescia, Italy. pasqualescagliola@virgilio.it.
Pasquale
P
Scagliola
MSD Italia S.r.L., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. nadia.bernardini@merck.com.
Nadia
N
Bernardini
MSD Italia S.r.L., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. daniela.de.feo@merck.com.
Daniela
D
de Feo
MSD Italia S.r.L., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. fabiola_beligotti@merck.com.
Fabiola
F
Beligotti
D000328:Adult; D002755:Choice Behavior; D003267:Contraception / Q000379:methods*; D003268:Contraception Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D003274:Contraceptive Devices, Female / Q000706:statistics & numerical data; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use; D037001:Directive Counseling / Q000379:methods*; D005260:Female; D006176:Gynecology / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
D003278:Contraceptives, Oral, Hormonal