Patient experiences switching from in‐clinic to self‐administration of injectable contraception in two Western US states

Abstract

AbstractObjectiveWe describe the experiences and preferences of women who switched from clinic‐administered intramuscular depot medroxyprogesterone acetate (DMPA‐IM) to self‐administered subcutaneous DMPA (DMPA‐SC) in the context of the COVID‐19 pandemic.MethodsWe conducted interviews with women in California and Washington about their experiences with self‐administered DMPA‐SC. We interviewed women after their first or second self‐administered DMPA‐SC injection and conducted follow‐up interviews after their third or fourth injection. We performed both thematic and descriptive content analyses.ResultsWe completed 29 interviews with 15 women. Most participants (n = 10) were between the ages of 20 and 39 and the majority (n = 12) used DMPA primarily for contraception. Most (n = 13) described self‐administered DMPA‐SC as “very easy” or “somewhat easy” to use and reported greater convenience, decreased pain, fewer logistical and financial challenges, increased privacy, and improved comfort with injection compared to DMPA‐IM. Participants identified difficulties obtaining DMPA‐SC from pharmacies and safe needle disposal as barriers. Most (n = 13) would recommend DMPA‐SC to a friend and desired to continue self‐administration beyond the COVID‐19 pandemic. Participants recommended counseling all patients about this option alongside other contraceptive methods, and offering clinician supervision, if desired.ConclusionWomen who switched from in‐clinic DMPA‐IM to self‐administered DMPA‐SC during the COVID‐19 pandemic preferred the latter and intended to continue self‐administration. Self‐administration of DMPA‐SC should be routinely offered and easily accessible to patients.