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Contraceptive Pearl: Is follow-up necessary after starting OCs?

Should we routinely schedule a follow-up visit after initiating oral contraceptives?

Many clinicians require a follow-up visit after initiating oral contraceptives. Is this necessary? Does this benefit patients?

Follow-up visits provide an opportunity to check patients’ blood pressure, adherence, side effects, and overall satisfaction with their new method. At first glance, this seems like a good idea. Who would object to assessing patients’ satisfaction with their contraception? However, follow-up visits can be problematic for patients due to cost or inconvenience. For patients who experience side effects on their new method, the visit may not occur at the right time — the previously scheduled visit can be either too early or too late to have a meaningful impact on adherence.

The Centers for Disease Control and Prevention advises us that routine follow-up is not necessary after initiating oral contraception. However, among complex or high-risk patients, follow-up may be a good idea.

All patients can benefit from having a way to reach their clinician easily. Patients who get prompt answers to their questions about side effects may be more likely to continue their method without taking the time for an office visit.

 

Helpful Resources:

Your Birth Control Choices Fact Sheet

Medical Eligibility Criteria for Initiating Contraception

 

Sources:

Curtis KM, Jatlaoui TC, Tepper NK, et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016;65(No. RR-4):1–66. DOI: http://dx.doi.org/10.15585/mmwr.rr6504a1.

Steenland MD, Zapata LB, Brahmi D, Marchbanks, PA, Curtis, KM. Appropriate follow up to detect potential adverse events after initiation of select contraceptive methods: a systematic review. Contraception. 2013 May;87(5):611-24. doi: 10.1016/j.contraception.2012.09.017.

Rosenberg MJ, Waugh MS, Burnhill MS.  Compliance, counseling and satisfaction with oral contraceptives: a prospective evaluation. Fam Plann Perspect. 1998 Mar-Apr;30(2):89-92, 104. PMID: 9561874.

 

Pharma-freeThe Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

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