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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REFERENCES
Pew Research Center. Health Fact Sheet. 2013. Available at: https://www.pewinternet.org/2013/01/15/health-online-2013/. Accessed on November 12, 2016.
- Surveys of physicians and electronic health information.N Engl J Med. 2010; 362: 859-860
- The online health care revolution.Pew Research Center, 2000 (Available at:)http://www.pewinternet.org/2000/11/26/the-online-health-care-revolution/Date accessed: February 21, 2018
- Quality and accuracy of sexual health information web sites visited by young people.J Adolesc Health. 2010; 47: 206-208
- Accuracy of information about the intrauterine device on the Internet.Am J Obstet Gynecol. 2016; 214 (e491–6): 499
- Quality of online health information about oral contraceptives from Hebrew-language websites.Isr J Health Policy Res. 2012; 1: 38
- Women's information-seeking behavior after receiving contraceptive versus noncontraceptive prescriptions.Contraception. 2013; 87: 824-829
- Disparities in rates of unintended pregnancy in the United States, 1994 and 2001.Perspect Sex Reprod Health. 2006; 38: 90-96
- Factors associated with contraceptive choice and inconsistent method use, United States, 2004.Perspect Sex Reprod Health. 2008; 40: 94—104
- No. 329-Canadian contraception consensus part 4 of 4 chapter 9: combined hormonal contraception.J Obstet Gynaecol Can. 2017; 39 (e225): 229-268
- Over-the-Internet availability of hormonal contraceptives regardless of risk factors.Contraception. 2006; 73: 372-375
- Canadian contraception consensus (part 1 of 4).J Obstet Gynaecol Can. 2015; 37: 936-942
- Over-the-counter access to oral contraceptives.Obstet Gynecol Clin North Am. 2015; 42: 619-629
- Disparities in knowledge and interest about benefits and risks of combined oral contraceptives.Eur J Contracept Reprod Health Care. 2011; 16: 183-193
- Google still world's most popular search engine by far, but share of unique searchers dips slightly.Search Engine Land, 2013 (Available at:)https://searchengineland.com/google-worlds-most-popular-search-engine-148089Date accessed: February 21, 2018
- Optimal search engine marketing strategy.Int J Electron Commerce. 2005; 10: 9-25
- Canadian contraception consensus.J Obstet Gynaecol Can. 2004; 26 (389-436): 347-387
- Medical eligibility criteria for contraceptive use.5th ed. Publications of the World Health Organization, Geneva2015 (Available at:)http://apps.who.int/iris/bitstream/10665/181468/1/9789241549158_eng.pdf?ua=1Date accessed: February 21, 2018
- Contraceptive technology.20th ed. Bridging the Gap Communications, New York2011
- Derivation of new readability formulas (Automated Readability Index, Fog Count and Flesch Reading Ease Formula) for Navy enlisted personnel.Naval Air Station, Memphis, TN1975
- DISCERN: an instrument for judging the quality of written consumer health information on treatment choices.J Epidemiol Community Health. 1999; 53: 105-111
- Assessing, controlling, and assuring the quality of medical information on the Internet: caveant lector et viewor–let the reader and viewer beware.JAMA. 1997; 277: 1244-1245
Health on the Net Foundation. HONcode. 2013. Available at: https://www.hon.ch/HONcode/Patients/Conduct.html. Accessed on February 21, 2018.
- Quality of Internet information related to the Mediterranean diet.Public Health Nutr. 2012; 15: 885-893
- Compliance, counseling and satisfaction with oral contraceptives: a prospective evaluation.Fam Plann Perspect. 1998; 30 (104): 89-92
- Effect of missed combined hormonal contraceptives on contraceptive effectiveness: a systematic review.Contraception. 2013; 87: 685-700
- Beyond reading level: a systematic review of the suitability of cancer education print and Web-based materials.J Cancer Educ. 2010; 25: 497-505
- Report of the National Work Group on Literacy and Health.J Fam Pract. 1998; 46: 168-176
- Promotion and marketing of bioidentical hormone therapy on the internet: a content analysis of websites.Menopause. 2017; 24: 1129-1135
Article info
Publication history
Published online: April 16, 2019
Footnotes
Competing interests: See Acknowledgements.
Each author has indicated that they meet the journal's requirements for authorship.
Identification
Copyright
© 2019 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
