Computer-Assisted provision of hormonal contraception in acute care settings

Background: We evaluated whether computerized counseling about contraceptive options and screening for contraindications increased women's subsequent knowledge and use of hormonal contraception. Methods: For the study 814 women aged 18-45 years were recruited from the waiting rooms of three emergency departments and an urgent care clinic staffed by non-gynecologists and asked to use a randomly selected computer module before seeing a clinician. Results: Women in the intervention group were more likely to report receiving a contraceptive prescription when seeking acute care than women in the control group (16% vs. 1%, p=.001). Women who requested contraceptive refills were not less likely than women requesting new prescriptions to have potential contraindications to estrogen (75% of refills vs. 52% new, p=.23). Three months after visiting the clinic, women in the intervention group tended to be more likely to have used contraception at last intercourse (71% vs. 65%, p=.91) and to correctly answer questions about contraceptive effectiveness, but these differences were not statistically significant. Conclusion: Patient-facing computers appear to increase access to prescription contraception for women seeking acute care.