251 - Pill Talk: Caregiver Insights into Non-Contraceptive Use of the Pill

Publication Number: 3243.251

Sanjana Taneja, St Barnabas Hospital, New York, New York, NY, United States; Nadia Scott, Saint Barnabas Children's Center Saint Barnabas Medical Center, Bronx, NY, United States; Tawana Winkfield-Royster, Saint Barnabas Hospital, Bronx, NY, United States; Ilana Stein, St. Barnabas Hospital, Bronx, NY, United States; Alexandra Gonzalez, SBH Health System, Bronx, NY, United States; Janine Adjo, SBH Health System, New York, NY, United States

Background: Dysmenorrhea affects about 90% of menstruating adolescent females. When symptomatic control with analgesics is not sufficient, hormonal contraceptive pills are a safe and effective alternative; however, their acceptance remains low. Qualitative studies conducted in adults reveal several apprehensions and misconceptions regarding the use of hormonal contraceptive pills. Often, parents act as surrogate decision makers for their children; therefore, it is important to assess their perception regarding the role of hormonal contraception amongst adolescents beyond contraception.

Objective: To understand caregiver knowledge, attitudes, and practices regarding the use of hormonal contraceptive pills for non-contraceptive uses.

Design/Methods: This was a cross-sectional study conducted via self-administered surveys in English and Spanish, distributed to the legal guardians of girls aged 8 years and above who presented to pediatric outpatient clinics in an urban population. Guardians who did not understand written or spoken English or Spanish were excluded from the study.

Results: The mean age of the patient population surveyed was 14.05 ± 2.5 years, with mothers constituting the majority of respondents (91%). There was no significant association between sociodemographic factors and willingness to use Oral Contraceptive Pills (OCPs) for non-contraceptive purposes. 25% of our patients complained of irregular menses, 43% of dysmenorrhea, 21% of heavy bleeding, and 36% of acne; however, there was no significant increase in willingness to use OCPs for symptomatic relief amongst caregivers of these patients. Good parental experiences with OCPs were positively correlated with their willingness to use OCPs for their daughter's non-contraceptive concerns [OR 6.8, p < 0.000015]. Most caregivers understood the utility of OCPs beyond contraception, but only 30% of caregivers felt OCPs were safe to use, and 75% caregivers were worried about the hormonal content of OCPs. 54% caregivers felt their daughters were too young to be using OCPs, irrespective of the age of the patient.

Conclusion(s): While most caregivers had good knowledge of the non-contraceptive uses of OCPs, their perception of safety was low, with nearly three-quarters feeling they were unsafe to use. Education level didn't modify caregivers' perception of safety and utility of OCPs, highlighting the imperative need for a broader approach to counseling regarding hormonal contraception and an imperative need to dispel myths regarding hormonal contraception across various sociodemographic groups.

Table 1: Population Characteristics.


Table 2: Knowledge, Attitudes, and Practices of Caregivers Regarding OCP Use.


Figure 1: Caregiver Willingness to Use OCPs for Patient's Menstrual Symptoms if Needed.