Promoting Safe Use of Isotretinoin by Increasing Contraceptive Knowledge | Acne | JAMA Dermatology | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.239.150.57. Please contact the publisher to request reinstatement.
Original Investigation
April 2015

Promoting Safe Use of Isotretinoin by Increasing Contraceptive Knowledge

Author Affiliations
  • 1School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 3Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 4Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 5Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 6now with Division of General Internal Medicine, University of California, Davis, Sacramento
JAMA Dermatol. 2015;151(4):389-393. doi:10.1001/jamadermatol.2014.4171
Abstract

Importance  Isotretinoin, a known teratogen, is strictly regulated through the iPLEDGE program. However, isotretinoin-exposed pregnancies continue to occur.

Objective  To evaluate an information sheet’s effect on women’s contraceptive knowledge.

Design, Setting, and Participants  Women aged 18 to 45 years visiting a dermatology practice completed anonymous surveys assessing their knowledge of the typical effectiveness of 8 contraceptive methods before and after reviewing an educational information sheet. Participants categorized each contraceptive as “most effective, >99% effective,” “medium effective, 92%-97% effective,” or “least effective, <89% effective” or indicated that they had “never heard of” it. All participants were recruited from a single dermatology clinic between April and May 2014. A total of 118 women were approached by consecutive sampling, and surveys were completed by 100 women.

Main Outcomes and Measures  Preintervention contraceptive effectiveness knowledge and change in contraceptive effectiveness knowledge after viewing the educational tool.

Results  Prior to viewing the contraceptive information sheet, more than half of women overestimated the typical effectiveness of condoms (75%), contraceptive injections (57%), and oral contraceptives (51%). Thirty-four percent had never heard of contraceptive implants, whereas 16% had never heard of an intrauterine contraceptive device (IUD). Participants correctly identified the typical effectiveness of only a mean (SD) of 3.8 (1.9) of the 8 contraceptives that they were asked about. Only 3% of participating women were able to correctly identify the typical effectiveness of all available contraceptives. On average, women spent less than 1 minute reviewing the contraceptive information sheet (mean [SD], 31 [27] seconds). After viewing the educational handout, the proportions of participants able to correctly identify the typical effectiveness of contraceptives increased for almost all methods (subdermal implant, 45% to 78% [P < .001]; IUD, 61% to 83% [P < .001]; injection, 28% to 44% [P = .02]; ring, 60% to 69% [P = .18]; patch, 50% to 71% [P = .002]; pills, 41% to 65% [P < .001]; condoms, 25% to 45% [P = .003]; withdrawal, 74% to 90% [P = .003]).

Conclusions and Relevance  A contraceptive information sheet can significantly improve patients’ contraceptive knowledge and may be a useful addition to efforts to prevent isotretinoin-induced birth defects.

×