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Author: Planned Parenthood


DMPA self-administration can improve contraceptive access, continuation, and autonomy

Commentary on the Burke et al. article Effect of self-administration versus provider-administered injection of subcutaneous depot medroxyprogesterone acetate on continuation rates in Malawi: a randomised controlled trial published in Lancet Global Health.

Institutional author(s): Planned Parenthood
Individual author(s): Julia E. Kohn
Publication date: March, 2018

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Increased 1-year continuation of DMPA among women randomized to self administration: results from a randomized controlled trial at Planned Parenthood

Self-administration of subcutaneous depot medroxyprogesterone acetate (DMPA-sc) is feasible, acceptable, and effective. Our objective was to compare one-year continuation of DMPA-sc between women randomized to self-administration versus clinic administration. We randomized 401 females ages 15–44 requesting DMPA at clinics in Texas and New Jersey to self-administration or clinic administration in a 1:1 allocation. Clinic staff taught participants randomized to self-administration to self-inject and observed the first injection; participants received instructions, a sharps container, and three doses for home use. Participants randomized to clinic administration received usual care. All participants received DMPA-sc at no cost and injection reminders via text message or email. We conducted follow-up surveys at six and 12 months.

Institutional author(s): Planned Parenthood
Individual author(s): Julia E. Kohn, Hannah R. Simons, Lisa Della Badia, Elissa Draper, Johanna Morfesis, Elizabeth Talmont, Anitra Beasley, Melanie McDonald, Carolyn L Westhoff
Publication date: December, 2017

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Self-administration of subcutaneous depot medroxyprogesterone acetate for contraception: feasibility and acceptability

Background: The objectives of the study were to assess feasibility, continuation rates and patient satisfaction with self-administration of subcutaneous depot medroxyprogesterone acetate (DMPA-SC). Materials and Methods: The study included 50 DMPA-seeking women between the ages of 18 and 49 years enrolled at two Florida Planned Parenthood health centers. Participants were taught self-injection during their initial study visit and, upon proficiency, self-injected one dose in clinic. Participants then injected a series of three more doses outside the health center over 9 months. Continuation rates, feasibility and acceptability were determined by analysis of four post-injection surveys. Results: Continuation of DMPA-SC at injection 4 was 74% (95% confidence interval 62%-86%). Overall, survey responses from the three at-home injections indicated the method to be convenient (95%), easy (87%) and recommendable to others (94%). Twenty percent of injections were met with difficulty, most commonly cited as plunger resistance. No pregnancies occurred in study. Conclusions: Continuation was high with DMPA-SC self-injection. Participants reported injection to be easy and convenient and are likely to recommend self-administration to other women. Device issues are one potential deterrent.

Institutional author(s): Planned Parenthood
Individual author(s): Sujatha Prabhakaran, Ashley Sweet
Publication date: November, 2011

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