Contraceptive Counseling: Telehealth Versus In-Person

A recent study published in the reproductive health journal Contraception revealed no differences in the interpersonal quality of contraceptive counseling delivered via telehealth versus in person. The findings help validate the use of telehealth in family planning.

“Telehealth is a really viable option for patients, and practitioners should consider including it more within their practices,” says Emily Freeman, DO, a physician in Cleveland Clinic’s Department of Obstetrics and Gynecology and a study author. “It’s patient-centered and provides better access for patients who many be juggling full-time jobs, childcare, transportation issues and other issues.”

Materials and methods

Freeman completed the study while participating in a fellowship in Complex Family Planning at Washington University in St. Louis. She and her colleagues pursued the research project after noting the increased use of telehealth during the COVID-19 pandemic.

“Across medical fields, we saw a rapid uptake and implementation of telehealth,” says Dr. Freeman. “But we really didn’t have a lot of information about the healthcare outcomes associated with a switch from our traditional, in-person model of care to a telehealth visit.”

The researchers administered a cross-sectional survey to patients presenting to a single Title X-funded clinic for a contraceptive visit. When scheduling an appointment for contraception, patients selected their preferred counseling modality – in-person or telehealth via video or telephone. After counseling, they assessed the quality of counseling using the 11-item Interpersonal Quality in Family Planning (IQFP) scale. Additional survey items included demographic characteristics, reproductive history and prior contraceptive use.

Study findings and next steps

During the 15-month study, 296 patients completed the survey and were included in the analysis:

• 51% opted for in-person counseling with a trained, non-clinician counselor
• 49% completed counseling via telehealth with a trained, non-clinician counselor
• In the telehealth group, 70% chose telephone and 30% chose video

“In addition to no difference in satisfaction from patients who chose a traditional, in-person visit for contraceptive counseling compared to telehealth, there were no differences between telephone and video visits,” says Dr. Freeman.

The researchers were surprised that more than two-thirds of patients who opted for telehealth counseling chose a telephone visit. That led the collaborators to pursue a secondary analysis examining the differences among patients who select telephone versus video counseling. In addition, they recently completed enrollment for a randomized controlled trial to obtain more data comparing the two telehealth modalities.

A growing body of evidence

The researchers believe that increasing the body of high-quality data related to contraceptive counseling is important.

“When done well, contraceptive counseling increases the likelihood that patients will find a contraceptive method they like and will continue to use. It’s a critical part of reducing unplanned or undesired pregnancies and helping patients achieve their life goals,” says Dr. Freeman. “Our study strengthens a growing body of evidence that telehealth is a viable option for patients. It allows us to meet patients where they are and continue to provide high-quality contraceptive counseling.”