Clinical Scorecard: Understanding Contraceptive Preferences, Knowledge, and Values in Women with Inflammatory Bowel Disease
At a Glance
Category
Detail
Condition
Inflammatory Bowel Disease (IBD)
Key Mechanisms
Active IBD at conception increases risk of adverse pregnancy outcomes; contraceptive use and counseling are critical to prevent unintended pregnancies and associated risks
Target Population
Women aged 18-45 years with IBD (Ulcerative colitis, Crohn’s disease, or IBD-unclassified)
Care Setting
Tertiary IBD centers and general healthcare settings involving gastroenterologists, IBD nurses, general practitioners, and gynecologists
Key Highlights
74% of women with IBD use contraception; oral contraceptive pills (28%) and barrier methods (18%) are most common; only 20% use long-acting reversible contraception (LARC).
Women with active IBD are more likely to use long-acting contraception (23%) compared to those in remission (17%).
Only 25% of women had discussed reproductive issues with their IBD clinician despite 85% being comfortable doing so; preferred counseling sources include IBD nurses (79%) and general practitioners (75%).
Guideline-Based Recommendations
Diagnosis
Assess IBD disease activity using patient-reported outcomes (PRO-2) and IBD-control questionnaires to inform reproductive planning.
Management
Prioritize contraceptive methods that are effective, easy to use, and have minimal side effects, with emphasis on long-acting reversible contraception to reduce unintended pregnancy risk.
Incorporate proactive contraceptive counseling into routine IBD care, especially for women of reproductive age.
Monitoring & Follow-up
Regularly evaluate disease activity and contraceptive use to optimize pregnancy outcomes and minimize risks associated with active IBD at conception.
Risks
Active IBD at conception is linked to miscarriage, intrauterine growth retardation, and preterm birth.
Short-acting contraceptive methods have higher failure rates leading to unintended pregnancies and associated adverse outcomes.
Patient & Prescribing Data
Women with IBD aged 18-45 years
Long-acting contraceptive use is low despite higher effectiveness; women prioritize contraceptive effectiveness, ease of use, and minimal side effects; knowledge gaps and lack of counseling are barriers to optimal contraceptive use.
Clinical Best Practices
Engage women with IBD in discussions about reproductive health and contraception proactively during clinical visits.
Utilize multidisciplinary teams including IBD nurses, general practitioners, and gynecologists for comprehensive contraceptive counseling.
Educate patients on the benefits of long-acting reversible contraception to reduce unintended pregnancies and improve pregnancy outcomes.
Tailor contraceptive counseling to individual disease activity status and patient preferences.
by Jimmy K Limdi, Sarah Rhodes, Eleanor Liu, Anish J Kuriakose Kuzhiyanjal, Matthew Brookes, Jennifer Farraye, Rachel Cannon, Elisabeth Woodhams, Francis A Farraye
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