Intrauterine devices (IUDs) are highly effective methods of
contraception, but use continues to lag behind less effective methods such as
oral contraceptive pills and condoms. Women who are aware of the actual
effectiveness of various contraceptive methods are more likely to choose the
IUD. Conversely, women who are misinformed about the safety of IUDs may be less
like to use this method. Individuals increasingly use the Internet for health
information. Information about IUDs obtained through the Internet may influence
attitudes about IUD use among patients.
Our objective was to evaluate the quality of information
about intrauterine devices (IUDs) among websites providing contraceptive
information to the public.
We developed a 56-item structured questionnaire to evaluate
the quality of information about IUDs available through the Internet. We then
conducted an online search to identify websites containing information about
contraception and IUDs using common search engines. The search was performed in
August 2013 and websites were reviewed in October 2015 to ensure no substantial
changes.
Our search identified over 2000 websites, of which 108 were
eligible for review; 105 (97.2%) of these sites contained information about
IUDs. Eighty-sex percent of sites provided at least one mechanism of the IUD.
Most websites accurately reported advantages of the IUD including that it is long-acting
(91%), highly effective (82%), and reversible (68%). However, only 30% of sites
explicitly indicated that IUDs are safe. Fifty percent of sites (n=53)
contained inaccurate information about the IUD such as an increased risk of
pelvic inflammatory disease beyond the insertion month (27%) or that women in
non-monogamous relationships (30%) and nulliparous women (20%) are not
appropriate candidates. Forty-four percent of websites stated that a mechanism
of IUDs is prevention of implantation of a fertilized egg. Only 3% of websites
incorrectly stated that IUDs are an abortifacient. More than a quarter of sites
listed an inaccurate contraindication to the IUD such as nulliparity, history
of pelvic inflammatory disease, or history of an ectopic pregnancy.
The quality of information about IUDs available on the
Internet is variable. Accurate information was mixed with inaccurate or
outdated information that could perpetuate myths about IUDs. Clinicians need
knowledge about accurate,, evidence-based Internet resources to provide to
women given the inconsistent quality of information available through online
sources.
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By: Madden T1, Cortez S2, Kuzemchak M2, Kaphingst KA3, Politi MC2.
- 1Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri 63110. Electronic address: maddent@wustl.edu.
- 2Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri 63110.
- 3Department of Communication and Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112.
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