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Abstract
Patient counseling is an important aspect of family planning. Patient choice, compliance,
and satisfaction with a contraceptive method depend heavily on the counseling experience.
This is especially true in the United Kingdom where contraceptives are provided to
patients at no direct cost to them. Women are therefore more likely to choose a contraceptive
option based on perceived desirability as opposed to cost. We surveyed physicians
from six family planning centers in the United Kingdom who have extensive experience
with levonorgestrel contraceptive implants with respect to counseling issues and patient
acceptability of levonorgestrel implants. The physicians reported on their experience
with 521 women. They acknowledged the need for and importance of counseling, and these
centers provided preinsertion counseling 100% of the time. Primary responsibility
for counseling was handled by the physician who spent, on average, 19 minutes per
patient discussing the advantages and risks of levonorgestrel implants. Physicians
felt that the majority of women (82%) accepting levonorgestrel implants had a positive
experience. The incidence of bleeding irregularities was consistent with that reported
in clinical trials, and this did not substantially affect the postinsertion acceptability
of the product. Effective counseling is no doubt responsible for the high level of
patient acceptance of these side effects. In a review of the literature, we found
counseling 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 literature findings.
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© 1996 Published by Elsevier Inc.
