Barriers and ways to overcome them when using an etonogestrel implant for contraception

• Published in: Medicinskij sovet no. 5; pp. 50 - 57
• Main Authors: Oboskalova, T. A., Vorontsova, A. V., Rosyuk, E. A., Koval, M. V.
• Format: Journal Article
• Language: English
• Published: 18.04.2023
• ISSN: 2079-701X; 2658-5790
• DOI: 10.21518/ms2023-104

Introduction . One of the ways to increase adherence to contraceptives is to switch to prolonged contraceptives that do not require daily use. Objective . Identify barriers to the use of Implanon by doctors and patients. Materials and methods . At the first stage, we analyzed the results of using LARC with etonogestrel with 44 patients in the period from 2016–2019. Then, using Google-Forms, we conducted an online survey of 36 women of reproductive age (18–49 years old). At the third stage, we evaluated the results of a survey of 27 obstetricians and gynecologists who were trained in the “Clinical training program for  the introduction and removal of  a  subcutaneous contraceptive implant  (radiopaque implant, 68  mg of etonogestrel)” in Yekaterinburg. Microsoft Office Exel 2016 application software packages were used for statistical data processing. Results . The majority of women – 80% (32) – wished to use implant with etonogestrel repeatedly. Women lack complete and real information about a subcutaneous implant with etonogestrel, which reduces the possibility of its use as a highly effective method of contraception. After the Implanon insertion/removal training, only 2 doctors (7.4%) voiced concerns about self-administration of the drug, and 25 (92.6%) cadets were ready for the introduction of a subcutaneous implant in practice and did not experience anxiety and fears before manipulation. Conclusions . The main barrier in choosing an implant with etonogestrel n among women was low awareness of the mechanism of action, benefits and possible side effects of an implant with etonogestrel. Preliminary training-training of obstetricians and gynecologists with the possibility of self-administration of the drug on a dummy in conditions close to real, significantly increases the commitment of specialists to the use of the drug.