The Quality of Information on Combined Oral Contraceptives Available on the Internet

Combined oral contraceptives (COC) are a popular choice among women. The Internet is an accessible and popular source of information on contraception. The objective of this study was to evaluate the quality of online information on COC.

A quantitative content analysis was completed on websites containing patient health information on COCs. The search was completed in October 2016 using Google; search terms included "birth control pill," "oral contraception," "oral birth control", "birth control," and "pregnancy prevention." The first three pages of search results were screened according to inclusion criteria. The DISCERN instrument and JAMA Benchmarks were used to assess quality. Websites were analyzed independently by two coders; discrepancies were resolved by third coder (Canadian Task Force Classification III).

Of the 155 websites identified, 32 were eligible for review. Most websites mentioned contraceptive benefit (81.3%), and half reported the typical effectiveness of COCs (53.1%). Commonly included non-contraceptive benefits were alleviation of dysmenorrhea (87.5%) and reduced blood loss (84.4%). Risk of venous thromboembolism was listed in 81.3% of websites, including stroke (56.3%) and myocardial infarction (46.9%); however, sites failed to include details with these risks. Only 46.9% provided information on starting COC; the first-day start method was the most common (40.6%). Nearly half lacked details on managing missed pills (46.9%). The mean Flesch-Kincaid Grade Level was 9 ± 2.0. The mean DISCERN score was 46.3 ± 9.37, indicating "fair" quality.

Online information on COCs was variable in quality, often missing key information for making informed decisions. Health care providers should be aware of information gaps when advising women to seek information online.