Adherence to Long-Acting Reversible Contraceptive Methods in Low- Income Young Women from the Caribbean Region of Colombia
Author(s)
Salcedo Mejía F1, Moyano L2, Parra Padilla D3, Alvis-Zakzuk NR2, Gómez De la Rosa F3, Alvis-Zakzuk N4, Jerez Arias M5, Paz Wilchez J6, Alvis-Guzman N7
1ALZAK Foundation, Cartagena, Colombia, 2ALZAK Foundation, Cartagena de Indias, BOL, Colombia, 3ALZAK Foundation, Cartagena, BOL, Colombia, 4Universidad de la Costa-CUC, Barranquilla, ATL, Colombia, 5Fundación SERSOCIAL, Cartagena, Colombia, 6MUTUALSER EPS, University of Cartagena Clínica Crecer, CARTAGENA DE INDIAS, Colombia, 7ALZAK Foundation, Universidad de Cartagena, Cartagena, BOL, Colombia
OBJECTIVES Adolescent pregnancies are more likely to occur in poor communities, commonly driven by lack of education and employment opportunities. We aimed to estimate the subdermal implant discontinuation rate and to establish the factors associated with the discontinuation of long-acting reversible contraceptive (LARC) methods in a cohort of poor women in the Caribbean region of Colombia. METHODS A retrospective cohort study of LARC method use through review of administrative record data was conducted. A population of 2,192 adolescents and young women between 10-24 years old enrolled in the “SER JOVEN” program and who received subdermal implants between 2015-2018 was considered for eligibility. This program is for young people affiliated to a health care company in the Caribbean region of Colombia. We realized a follow-up time-person of the retrospective cohort, and we estimated the incidence of discontinuation of the subdermal implant at six months, one year, two years, and three years. Kaplan-Meier estimator for survival curves, and Cox proportional hazard model were used to ascertain factors associated with method discontinuation risk. A p-value <0.050 was considered significant. RESULTS A total of 2,192 women were selected with a mean (standard deviation -SD) age of 19.4 (2.8) years and a mean duration of use of subdermal implant of 2.6 (0.8) years. We estimated the subdermal implant discontinuation rate at six months in 0.7% [CI95% 0.3-1.1], a year later in 1.5% [CI95% 1-2], two years later in 2.1% [CI95% 1.5-2.7] and finally at three years in 2.2% [CI95% 1.6-2.8]. Women who stated they have children at baseline were about 70% less risk to discontinue subdermal implants (HR: 0.3 [CI95% 0.1 – 0.8]). CONCLUSIONS Adolescent pregnancy is a public health problem, and it is an important cause of poverty and illness. Then, the use of subdermal implants is an effective alternative to prevent unintended pregnancies.
Conference/Value in Health Info
2021-05, ISPOR 2021, Montreal, Canada
Value in Health, Volume 24, Issue 5, S1 (May 2021)
Code
PIH28
Topic
Epidemiology & Public Health, Medical Technologies
Topic Subcategory
Medical Devices, Public Health
Disease
Reproductive and Sexual Health