Tailored and Interactive Mobile Telehealth Contraceptive Counseling Compared With In-Person Care: Systematic Review...

Area of Science:

• Reproductive Health
• Telemedicine
• Evidence-Based Medicine

Background:

• Effective contraceptive methods (ECMs) are crucial for reducing maternal mortality.
• High-quality, person-centered contraceptive counseling improves uptake but faces access barriers.
• Telehealth offers potential for comprehensive contraceptive care, but its effectiveness needs evaluation.

Purpose of the Study:

• To assess the effectiveness and acceptability of tailored, interactive telehealth contraceptive counseling (TECC) versus in-person counseling.
• To compare TECC with traditional in-person counseling for contraceptive method use and satisfaction.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing TECC and in-person counseling.
• Searched major databases (MEDLINE, Embase, Web of Science, Cochrane Library) up to October 2025.
• Assessed outcomes including ECM use, LARC use, method choice, satisfaction, and method switching, with risk of bias and GRADE certainty evaluations.

Main Results:

• Low to very low certainty evidence from 9 RCTs (5353 participants) was included.
• Adjunct TECC showed no clear effect on short-term ECM use or choice.
• A small, statistically significant effect favoring TECC was observed for ECM use at 6-12 months (RR 1.07; 95% CI 1.002-1.130).
• Evidence for LARC use/choice and satisfaction was very uncertain due to heterogeneity; no data on method switching were available.

Conclusions:

• Adjunct TECC demonstrates minimal to no impact on contraceptive use compared to in-person care, with low certainty.
• Evidence regarding long-term use, method choice, LARC, and satisfaction remains highly uncertain.
• Future research should focus on standalone TECC models and factors influencing effectiveness, including long-term outcomes.