School of Medicine and Health Sciences Poster Presentations

Title

Emergency Contraception Candidacy in the Pediatric Emergency Department

Document Type

Poster

Keywords

Emergency Medicine; Adolescent; Women's Health; Emergency Contraception

Publication Date

Spring 2017

Abstract

Purpose: The majority of adolescent pregnancies are unintended. Adolescents who access the emergency department (ED) for care may be at high risk for unplanned pregnancy. The purpose of this study was to identify the proportion of adolescent females presenting to an urban ED who may be candidates for emergency contraception (EC).

Methods: This was a secondary analysis of a randomized control trial conducted in an urban pediatric ED designed to determine whether provision of clinical decision support derived from a computerized sexual health screening tool resulted in increased testing for sexually transmitted infections among adolescents (ages 14-19 years) at high risk for infection. We calculated the prevalence of adolescent females who met candidacy for emergency contraception and the proportion of EC qualifying females who were interested in speaking to a clinician about EC.

Results: 444 adolescent females were enrolled in this trial. The study population had a mean age of 16.25 years (SD +/- 1.65); 75.3% were non-Hispanic Black; and 25.5% were covered by private insurance. Overall, 210 (47.3%) of females were sexually active. 70 (33.3%) of those females reported vaginal intercourse within the last five days and were eligible for EC. Only 11 (15.7%) of eligible females, expressed interest in speaking with a clinician about EC (7 in intervention arm and 4 in usual care arm). Clinicians prescribed EC to 2 of 11 (18.2%) patients who expressed interest in EC receipt.

Conclusions: Although a large proportion of adolescents were eligible for EC, few expressed interest in speaking with a clinician about EC. However, a large proportion of adolescents who were interested in EC receipt did not receive EC. Further studies should investigate adolescent attitudes towards ED-prescribed EC and barriers to EC provision by clinical staff.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Comments

Poster to be presented at GW Annual Research Days 2017.

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Emergency Contraception Candidacy in the Pediatric Emergency Department

Purpose: The majority of adolescent pregnancies are unintended. Adolescents who access the emergency department (ED) for care may be at high risk for unplanned pregnancy. The purpose of this study was to identify the proportion of adolescent females presenting to an urban ED who may be candidates for emergency contraception (EC).

Methods: This was a secondary analysis of a randomized control trial conducted in an urban pediatric ED designed to determine whether provision of clinical decision support derived from a computerized sexual health screening tool resulted in increased testing for sexually transmitted infections among adolescents (ages 14-19 years) at high risk for infection. We calculated the prevalence of adolescent females who met candidacy for emergency contraception and the proportion of EC qualifying females who were interested in speaking to a clinician about EC.

Results: 444 adolescent females were enrolled in this trial. The study population had a mean age of 16.25 years (SD +/- 1.65); 75.3% were non-Hispanic Black; and 25.5% were covered by private insurance. Overall, 210 (47.3%) of females were sexually active. 70 (33.3%) of those females reported vaginal intercourse within the last five days and were eligible for EC. Only 11 (15.7%) of eligible females, expressed interest in speaking with a clinician about EC (7 in intervention arm and 4 in usual care arm). Clinicians prescribed EC to 2 of 11 (18.2%) patients who expressed interest in EC receipt.

Conclusions: Although a large proportion of adolescents were eligible for EC, few expressed interest in speaking with a clinician about EC. However, a large proportion of adolescents who were interested in EC receipt did not receive EC. Further studies should investigate adolescent attitudes towards ED-prescribed EC and barriers to EC provision by clinical staff.