Self-administration of Depot Provera (DMPA) – the way forward?
F. Lakha, A. Glasier
Lothian Primary Care NHS Trust and Department of Obstetrics and
Gynaecology, University of Edinburgh, Edinburgh, UK
Introduction: Depo Provera (DMPA) is a popular method of
contraception in the UK, but the need to attend for injection every 12 weeks
involves costs to the health service and inconvenience to the user. A micronised
preparation of DMPA for subcutaneous use has been developed and will allow
self-administration. In anticipation of subcutaneous DMPA becoming available, we
undertook a survey to determine what percentage of women would want to
self-administer the injection and what would be the most suitable method for
reminding women to do it.
Methods: The survey was undertaken in a large family planning clinic
in Edinburgh, Scotland. During one calendar month, a self-administered
questionnaire was offered to every woman attending for repeat DMPA injection. A
questionnaire was attached to every packet of DMPA thus ensuring 100% targeting
of DMPA users. All data will be entered onto a Microsoft access database and
analysed using SPSS.
Results: 176 women completed the questionnaire, there were no refusals.
118 women (67%) were keen to self-administer DMPA. 89% of these women felt that
they would need a reminder for when to inject. The most popular request was for
a verbal reminder (33%) of the next 3 dates for injection at the time of their
annual review; 30% of women preferred to receive a letter, and 25% a text
message, just prior to the date of the next injection. Of the 58 women who did
not wish to self-administer DMPA, the commonest reason was a dislike or fear of
needles (62%); 43% were concerned that they would administer the contraceptive
incorrectly; whilst 33% felt it was important to see a doctor every 3 months.
Forgetting to self-administer was a concern to only 12% of women.
Conclusions: Most women are interested in self-administration of DMPA
and would like to be informed of future administration dates at their annual
review.
