Recent research on shared decision making in contraceptive counselling has revealed two important insights. The COCO study (full title: Evaluation of a patient-centred, needs-based approach to support shared decision making in contraceptive counselling) shows that a structured approach to counselling leads to a high level of satisfaction among both women and gynaecologists. Moreover, six months after counselling women in this approach are on average more satisfied with their chosen method of contraception.

The COCO study is a prospective study in Germany in which 1176 women and 92 gynaecologists participated. Women completed an intake questionnaire about their contraceptive needs prior to the counselling interview. This enabled women to indicate in advance what they considered important in choosing a contraceptive method. This study shows that this structured approach leads to a high degree of satisfaction for 95% of the women and 72% of the gynaecologists.

After the counselling interview, on average 56% of the women indicated to be interested in changing their method of contraception. Among the group of women with an IUD, a much smaller number wanted to change method: among women with a hormonal IUD this was only 20% and for women with a copper IUD 18%.

Moreover, this study shows that 6 months after the counselling women were more satisfied with their used method of contraception than they were before the counselling. Before the counselling 33% were very satisfied and 31% were very dissatisfied. After the counselling 65% were very satisfied and only 5% of the women were very dissatisfied. Thus, actively involving women in the joint decision making process seems to play an important role in contraception counselling.

Reference:
Bitzer, J., Oppelt, P. G., & Deten, A. (2021). Evaluation of a patient-centred, needs-based approach to support shared decision making in contraceptive counselling: the COCO study. The European Journal of Contraception & Reproductive Health Care, 26(4), 326-333. https://doi.org/10.1080/13625187.2021.1908539