title: Comparison of two strategies for the administration of injectable depot medroxyprogesterone acetate: among women who returned to a family planning clinic at three- or six-month intervals.
abstract: OBJECTIVE
  The aim of this study was to compare the clinical performance of depot medroxyprogesterone acetate (DMPA) in women who received injections every 3 months at the Family Planning Clinic, and those who received every other injection at a health care facility near their place of residence, only returning to the clinic every 6 months.
  
  
  METHODS
  The medical charts of DMPA users from 2 January 1980 through 31 December 2012 were evaluated for this study. Two cohorts of women were created and compared: those who regularly received DMPA injections every 3 months (3-month group) at the clinic and those who received alternating 3-month injections at a health care facility near their residence house, returning to the clinic every 6 months for an injection (6-month group). In addition, effectiveness rates, reasons for discontinuation, and continuation rates were evaluated.
  
  
  RESULTS
  Overall, 2637 women received all injections at 3-month intervals at the clinic, and 1190 women received every other injection at a health care facility near their residence. The women in the 3-month group had higher pregnancy rates and higher discontinuation rates (with the exception of discontinuation due to the loss of libido).
  
  
  CONCLUSIONS
  The women who received alternating injections near their homes were more likely to continue using DMPA as a contraception method and presented lower pregnancy and discontinuation rates (for the majority of reasons), when compared to those women who returned to the clinic every 3 months.
authors.affiliation: a Family Planning Clinic, Department of Obstetrics and Gynaecology , School of Medical Sciences and National Institute of Hormones and Women's Health, University of Campinas (UNICAMP) , Campinas , São Paulo , Brazil.
authors.forename: Jéssica M
authors.initials: JM
authors.lastname: Ferreira
authors.affiliation: a Family Planning Clinic, Department of Obstetrics and Gynaecology , School of Medical Sciences and National Institute of Hormones and Women's Health, University of Campinas (UNICAMP) , Campinas , São Paulo , Brazil.
authors.forename: Bruna F
authors.initials: BF
authors.lastname: Bottura
authors.affiliation: a Family Planning Clinic, Department of Obstetrics and Gynaecology , School of Medical Sciences and National Institute of Hormones and Women's Health, University of Campinas (UNICAMP) , Campinas , São Paulo , Brazil.
authors.forename: Mayara P
authors.initials: MP
authors.lastname: Gonçalves
authors.affiliation: a Family Planning Clinic, Department of Obstetrics and Gynaecology , School of Medical Sciences and National Institute of Hormones and Women's Health, University of Campinas (UNICAMP) , Campinas , São Paulo , Brazil.
authors.forename: Ilza
authors.initials: I
authors.lastname: Monteiro
authors.affiliation: a Family Planning Clinic, Department of Obstetrics and Gynaecology , School of Medical Sciences and National Institute of Hormones and Women's Health, University of Campinas (UNICAMP) , Campinas , São Paulo , Brazil.
authors.forename: Luis
authors.initials: L
authors.lastname: Bahamondes
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D003692:Delayed-Action Preparations; D005260:Female; D006268:Health Facilities; D006801:Humans; D053208:Kaplan-Meier Estimate; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013997:Time Factors; D014195:Travel; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate
keywords: Depot-medroxyprogesterone acetate; continuation rate; service provision; strategies