Telemedicine for Contraceptive Counseling During the COVID-19 Pandemic: Referral Patterns and Attendance at Follow-Up Visits

Abstract

Objective:

To describe referral patterns and attendance at follow-up visits for patients who received contraceptive counseling via telemedicine during the COVID-19 pandemic.

Study Design:

This is a prospective study of patients seen remotely during the early phase of the COVID-19 pandemic in New York City. We tracked referral rates, referral reasons, in-person visit show rates, and additional visits. We also administered a patient survey at 6 months. Using Stata SE 16, we conducted a multivariable modified Poisson regression with robust error variances to examine the predictors of attending an in-person visit within 30 days.

Results:

We included 169 patients who had visits between April 1 and June 30, 2020. Of these, 109 (64.5%) were referred for in-person visits, and 83 (76.1%) of those referred attended within 30 days. The most common reasons for referral were long-acting reversible contraception (LARC) removal and insertion. The relative risk (RR) of attending a visit within 30 days of referral was 24% higher for those referred for LARC removal compared with those referred for other reasons (RR 1.24, 95% confidence interval [CI] 1.08–1.69), and it was 29% lower for those aged 18–25 compared with those in the reference age (26–35) group (RR 0.71, 95% CI 0.51–0.98). At 6 months, 69.4% of patients were still using the method they decided on at the telemedicine visit, and 44.4% would choose telemedicine for their next contraception visit.

Conclusions:

Approximately one third of patients seeking contraceptive counseling via telemedicine did not seek additional in-person visits over a 6-month period. Among the patients referred for in-person visits, referral reason and patient age may impact attendance rates.