Long-acting reversible contraception should be offered routinely
Intrauterine devices are more cost-effective than oral contraceptive
pills |
Women should be offered long-acting
reversible contraception (LARC) as part of any discussion about contraceptive choices, a new guideline from the National Institute for Health and Clinical Excellence recommends.
NICE says that contraceptive service providers should be aware that increasing
the uptake of long-acting methods — including intrauterine methods,
injectable contraceptives and implants — will reduce the number
of unplanned pregnancies and therefore save the NHS money. This reduction
in unplanned pregnancies makes LARC methods more cost-effective than
the combined oral contraceptive pill, even at one year of use, the guideline
says. More specifically, of the long-acting contraceptives, intrauterine
methods and implants are more cost-effective than injectable contraceptives,
it adds.
Information and counselling that should be provided to women considering
LARC methods is also specified in the guideline. Verbal and written information
should be provided on contraceptive efficacy, duration of use, risks
and possible side effects, non-contraceptive benefits, the procedure
for initiation and removal or discontinuation and when to seek help while
using the method. Choices of LARC method for different groups of women,
including women taking medicines, women with epilepsy and women at risk
of sexually transmitted infections, is also included.
Training of health care professionals is addressed in the guideline.
NICE says that those providing advice to women about contraceptive choices
should be competent to help them compare the risks and benefits of all
methods and to manage common side effects and problems.
Service providers that do not provide LARC should be able to refer women
to a provider that does, says the guideline.
An information leaflet, developed by NICE in association with the fpa,
has also been produced. It aims to help women make informed decisions
about LARC by setting out the different features of each method (see
Notice-board, p545). |
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