Attributes and Trade-Offs Impacting Contraceptive Choice: A Discrete Choice Experiment

Area of Science:

• Contraceptive research
• Reproductive health
• Health economics

Background:

• Understanding patient and provider preferences is crucial for effective contraceptive counseling and uptake.
• Previous research has not fully quantified the trade-offs involved in contraceptive method selection.

Purpose of the Study:

• To quantify the preferences and trade-offs of women choosing contraception.
• To identify key attributes influencing decision-making for both women and healthcare providers (HCPs).

Main Methods:

• A discrete choice experiment (DCE) was used to evaluate seven contraceptive attributes.
• 307 women and 305 HCPs in the US participated in the study.
• Preferences were estimated using conditional logistic regression.

Main Results:

• Women highly valued effectiveness (RI=30.7%) and low cardiovascular risk (RI=24.0%).
• HCPs prioritized effectiveness (RI=37.0%-40.1%) and favored long-acting reversible contraception (LARC) attributes.
• Women preferred daily oral contraceptive use and arm placement for LARC over uterine placement.

Conclusions:

• Aligning contraceptive care with women's goals requires incorporating stated preferences into shared decision-making.
• Education emphasizing patient autonomy across all contraceptive methods is essential.