Abstract
Introduction
Telehealth has the potential to increase contraceptive access. Little is known about
the characteristics of people using online prescribing platforms or whether these
services help fill access gaps.
Methods
We analyzed requests for contraception submitted between July 2015 and September 2017
to an online prescribing platform that offers sexual and reproductive care in the
United States. We analyzed the characteristics of people seeking contraceptives, prevalence
of contraindications to hormonal contraception among contraceptive seekers, and extent
to which online prescribing may close contraceptive access gaps.
Results
A total of 38,439 requests for prescription hormonal birth control were received during
the study period, with requests increasing dramatically over this timeframe as the
platform expanded operations to an increasing number of states. Methods were dispensed
in response to 63% of requests. In this population seeking contraception, an estimated
1.2% had a contraindication to progestin-only pills, and an estimated 12.0% of patients
who reported their blood pressure had a contraindication to combined hormonal methods.
Few requests came from patients younger than 18 (1.2%). In multivariable negative
binomial models, urban counties had a larger concentration of requests, whereas counties
with higher rates of uninsurance and poverty had lower rates of requests.
Conclusions
Results suggest that the population seeking contraception from one online prescribing
platform has similar levels of contraindications to hormonal contraceptives as found
in prior research. Future research should seek to understand why utilization of this
online prescribing platform was lower among young people, how to expand outreach to
rural populations, and what underlies individuals’ decisions about using these services.
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Biography
Alexandra Wollum, MPH, is a Senior Associate Research Scientist at Ibis Reproductive Health. Her research examines barriers and access to reproductive health services including contraception and abortion and the impact of social, economic, and contextual factors on reproductive health.
Biography
Carmela Zuniga, MA, is a Senior Research Manager at Ibis Reproductive Health. Her research focuses on documenting the contraceptive and abortion experiences of understudied populations.
Biography
Kate Grindlay, MSPH, is a research consultant with Ibis Reproductive Health. Her research focuses on novel forms of reproductive health access in the United States.
Biography
Daniel Grossman, MD, is the Director of Advancing New Standards in Reproductive Health at the University of California, San Francisco. His research focuses on improving access to contraception and safe abortion and evaluating the impact of integrating reproductive health and HIV services.
Article info
Publication history
Published online: September 28, 2022
Accepted:
August 5,
2022
Received in revised form:
July 14,
2022
Received:
December 20,
2021
Footnotes
This study was supported by the David and Lucile Packard Foundation (Grant number 2015-63012). The funders had no involvement with the study design; collection, analysis, and interpretation of the data; writing of the manuscript; or the decision to submit the manuscript for publication.
Identification
Copyright
© 2022 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved.
