IMPACT OF PATIENT COUNSELING ON ACCEPTANCE OF THE LEVONORGESTREL IMPLANT CONTRACEPTIVE IN THE UNITED-KINGDOM

Patient counseling is an important aspect of family planning. Patient choice, compliance, and satisfaction with a contraceptive method depen d heavily on the counseling experience. This is especially true in the United Kingdom where contraceptives are provided to patients at no di rect cost to them. Women are therefore more Likely to choose a contrac eptive option based on perceived desirability as opposed to cost. We s urveyed physicians from six family planning centers in the United King dom who have extensive experience with levonorgestrel contraceptive im plants with respect to counseling issues and patient acceptability of levonorgestrel implants. The physicians reported on their experience w ith 521 women. They acknowledged the need for and importance of counse ling, and these centers provided preinsertion counseling 100% of the t ime. Primary responsibility for counseling was handled by the physicia n who spent, on average, 19 minutes per patient discussing the advanta ges and risks of levonorgestrel implants. Physicians felt that the maj ority of women (82%) accepting levonorgestrel implants had a positive experience. The incidence of bleeding irregularities was consistent wi th that reported in clinical trials, and this did not substantially af fect the postinsertion acceptability of the product. Effective counsel ing is no doubt responsible for the high level of patient acceptance o f these side effects. In a review of the literature, we found counseli ng to be a significant factor in a woman's tolerance of contraceptive- induced bleeding irregularities, which are frequently experienced with levonorgestrel implants. The results of our survey support the litera ture findings.