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

Published:April 16, 2019DOI:https://doi.org/10.1016/j.jogc.2019.01.024

      Abstract

      Objective

      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.

      Methods

      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).

      Results

      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.

      Conclusion

      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.

      Résumé

      Objectif

      Les contraceptifs oraux combinés (COC) sont un choix populaire chez les femmes. L'Internet est une source d'information accessible et populaire sur la contraception. L'objectif de cette étude était d'évaluer la qualité des renseignements sur les COC trouvés en ligne.

      Méthodologie

      Une analyse quantitative du contenu a été effectuée sur les sites Web présentant des renseignements de santé sur les COC. La recherche a été faite en octobre 2016 sur Google, avec les termes « birth control pill » [pilule contraceptive], « oral contraception » [contraception orale], « oral birth control » [contraceptif oral], « birth control » [contraception] et « pregnancy prevention » [prévention de la grossesse]. Les trois premières pages de résultats ont été filtrées en fonction des critères d'inclusion. La qualité a été évaluée à l'aide de l'instrument DISCERN et des critères du JAMA. Les sites Web ont été analysés séparément par deux chercheurs; les désaccords ont été résolus par un troisième chercheur (classification III du Groupe d'étude canadien).

      Résultats

      Sur les 155 sites Web recensés, 32 étaient admissibles à l'évaluation. La plupart des sites (81,3 %) mentionnaient l'effet contraceptif, et la moitié (53,1 %) indiquaient l'efficacité typique des COC. Les avantages non contraceptifs souvent présentés étaient le soulagement de la dysménorrhée (87,5 %) et la réduction des pertes sanguines (84,4 %). Le risque de thromboembolie veineuse était indiqué sur 81,3 % des sites Web, avec le risque d'AVC (56,3 %) et d'infarctus du myocarde (46,9 %); cependant, les sites n'accompagnaient pas ces mentions de renseignements. Seuls 46,9 % des sites fournissaient des renseignements sur l'amorce de la contraception orale; la méthode du premier jour était la plus mentionnée (40,6 %). Près de la moitié n'offraient pas d'information sur la marche à suivre en cas de pilule oubliée (46,9 %). Selon le test de Flesch-Kincaid, le niveau de lisibilité moyen était de 9e année (écart-type : ± 2,0). Le score DISCERN moyen était de 46,3 (± 9,37), ce qui signifie une qualité « correcte ».

      Conclusion

      Les renseignements sur les COC trouvés en ligne variaient en qualité et étaient souvent insuffisants pour la prise de décisions éclairées. Les fournisseurs de soins de santé devraient être au courant de ces lacunes lorsqu'ils conseillent à des femmes de chercher de l'information en ligne.

      Key Words

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