Telemedicine for Contraceptive Counseling During the COVID-19 Pandemic: Referral Patterns and Attendance at Follow-Up Visits.

Objective: To describe referral patterns and attendance at follow-up visits for patients who received contraceptive counseling via telemedicine during the COVID-19 pandemic. Study Design: This is a prospective study of patients seen remotely during the early phase of the COVID-19 pandemic in New York City. We tracked referral rates, referral reasons, in-person visit show rates, and additional visits. We also administered a patient survey at 6 months. Using Stata SE 16, we conducted a multivariable modified Poisson regression with robust error variances to examine the predictors of attending an in-person visit within 30 days. Results: We included 169 patients who had visits between April 1 and June 30, 2020. Of these, 109 (64.5%) were referred for in-person visits, and 83 (76.1%) of those referred attended within 30 days. The most common reasons for referral were long-acting reversible contraception (LARC) removal and insertion. The relative risk (RR) of attending a visit within 30 days of referral was 24% higher for those referred for LARC removal compared with those referred for other reasons (RR 1.24, 95% confidence interval [CI] 1.08-1.69), and it was 29% lower for those aged 18-25 compared with those in the reference age (26-35) group (RR 0.71, 95% CI 0.51-0.98). At 6 months, 69.4% of patients were still using the method they decided on at the telemedicine visit, and 44.4% would choose telemedicine for their next contraception visit. Conclusions: Approximately one third of patients seeking contraceptive counseling via telemedicine did not seek additional in-person visits over a 6-month period. Among the patients referred for in-person visits, referral reason and patient age may impact attendance rates.

Telemedicine for contraceptive counseling: Patient experiences during the early phase of the COVID-19 pandemic in New York City.

OBJECTIVE: During theCOVID-19 pandemic, many clinicians increased provision of telemedicine services. This study describes patient experiences with telemedicine for contraceptive counseling during the COVID-19 pandemic in New York City. STUDY DESIGN: This is a mixed-methods study which includes a web-based or phone survey and in-depth phone interviews with patients who had telemedicine visits for contraception. RESULTS: A total of 169 patients had eligible telemedicine visits between April 1 and June 30, 2020. Of these, 86 (51%) responded to the survey, and 23 (14%) participated in the interviews. We found that 86% of survey respondents were very satisfied with the telemedicine visit, and 63% said it completely met their needs. A majority (73%) strongly agreed that these visits should be maintained after the COVID-19 pandemic, and half (51%) would be very likely to choose them over in-person visits. In-depth interviews highlighted the convenience of telemedicine, especially for those with work or parenting responsibilities. Although some patients had in-person visits after telehealth, many appreciated the counseling they received remotely, and found the subsequent in-person visits more efficient. Patients identified visits that do not require physical exams as ideal visits for telehealth, and some hoped that all or most of their future visits would be telehealth visits. Many patients (43%) expressed a preference for phone over video visits. CONCLUSIONS: Patients reported an overall positive experience with telemedicine visits for contraceptive counseling during the COVID-19 pandemic. They appreciated the convenience of telemedicine visits and valued the virtual counseling experience. IMPLICATIONS: Health care providers who initiated or expanded telemedicine services for contraceptive counseling during the COVID-19 pandemic should consider continuing to offer them after the pandemic. At the policy level, these findings favor expanding access to telemedicine and providing reimbursement for virtual visits, including telephone visits.

Fresh ideas, workarounds during pandemic can increase access to contraception: The pandemic has forced us to get more creative in managing patients' needs, especially when it comes to contraception

The article advises obstetricians and gynecologists about the various methods and strategies they can use to increase access to contraception during the COVID-19 pandemic. Topics mentioned include immediate postpartum long-acting reversible contraception (LARC), virtual health care or telehealth services, and mail-order pharmacies through mobile applications. Also mentioned are the other items for consideration including the safety of contraceptive options for patients with COVID-19.

Telemedicine for contraceptive counseling: An exploratory survey of US family planning providers following rapid adoption of services during the COVID-19 pandemic.

OBJECTIVE: During the COVID-19 pandemic, many clinicians started offering telemedicine services. The objective of this study is to describe the experience of US family planning providers with the rapid adoption of telemedicine for contraceptive counseling during this period. STUDY DESIGN: This is a cross-sectional web-based survey of family planning providers practicing in the United States. RESULTS: A total of 172 providers completed the survey (34% response rate). Of these, 156 (91%) provided telemedicine services in the 2 months preceding the survey. Most (78%) were new to telemedicine. About half (54%) referred less than a quarter of contraception patients for in-person visits, and 53% stated that the most common referral reason was long-acting reversible contraceptive (LARC) insertion. A majority of providers strongly agree that telemedicine visits are an effective way to provide contraceptive counseling (80%), and that this service should be expanded after the pandemic (84%). If asked to provide telemedicine visits after the pandemic, 64% of providers would be very happy about it. Many providers used personal phones or smartphones to conduct telemedicine visits but stated that ideal devices would be work-issued computers, tablets, or phones. More than half (59%) of providers prefer video over phone visits. CONCLUSIONS: Family planning clinicians in the United States reported a positive experience with telemedicine for contraceptive counseling during the early stage of the COVID-19 pandemic and believe that this service should be expanded. Clinicians seem to prefer using work-issued devices and conducting video rather than phone visits. IMPLICATIONS: Telemedicine is a promising option for providing contraceptive counseling even beyond the COVID-19 pandemic. An investment in hospital or clinic-issued devices that allow for video conferencing may optimize clinicians' telemedicine experience.