Self-Screening for Contraindications to Contraception: Are Adolescents up to the Task?

• Published in: Journal of adolescent health Vol. 69; no. 4; pp. 533 - 534
• Main Author: Holland-Hall, Cynthia
• Format: Journal Article
• Language: English
• Published: New York Elsevier Inc 01.10.2021; Elsevier BV
• Subjects: Adolescents; Birth control; Cardiology; Clinical information; Clinics; Contraceptives; Critical incidents; Medical conditions; Medical screening; Neurology; Patient safety; Physicians; Primary care; Rheumatology; Teenagers; Unsafe; Young adults
• ISSN: 1054-139X; 1879-1972; 1879-1972
• DOI: 10.1016/j.jadohealth.2021.07.008

In this issue of the Journal of Adolescent Health, Wilkinson et al. (7) present their study of the ability of adolescents and young adults 14-21 years old to self-screen for contraindications to hormonal contraception using such a check list. In order to ensure adequate numbers of subjects with medical conditions potentially affecting contraceptive choice, the investigators recruited from several subspecialty clinics (neurology, rheumatology, and cardiology) as well as primary care clinics. Each subject's performance was compared to the assessment of her primary care or subspecialty physician (the "gold standard"). Discordance between patient and physician was further classified into "safe discordance" and "unsafe discordance." A safe discordance was defined when the patient identified a condition that was a potential contraindication to contraceptive use but the physician did not note such a condition. Unsafe discordance was noted when the physician identified a contraindication to hormonal contraceptive use but the patient failed to do so. Unsafe discordance would theoretically place the patient at increased risk of pregnancy or some other adverse event if her self-screen was the only source of medical information used to guide contraceptive choice.