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. 2020 Sep 15;22(9):e20632.
doi: 10.2196/20632.

Real-World Evidence on the Effect of Missing an Oral Contraceptive Dose: Analysis of Internet Search Engine Queries

Irit Hochberg  1   2 , Sharon Orshalimy  3 , Elad Yom-Tov  4   5
Affiliations

Real-World Evidence on the Effect of Missing an Oral Contraceptive Dose: Analysis of Internet Search Engine Queries

Irit Hochberg et al. J Med Internet Res. .

Abstract

Background: Oral contraceptives (OCs) are a unique chronic medication with which a memory slip may result in a threat that could change a person's life course. Subjective concerns of missed OC doses among women have been addressed infrequently. Anonymized queries to internet search engines provide unique access to concerns and information gaps faced by a large number of internet users.

Objective: We aimed to quantitate the frequency of queries by women seeking information in an internet search engine, after missing one or more doses of an OC; their further queries on emergency contraception, abortion, and miscarriage; and their rate of reporting a pregnancy timed to the cycle of missing an OC.

Methods: We extracted all English-language queries submitted to Bing in the United States during 2018, which mentioned a missed OC and subsequent queries of the same users on miscarriage, abortion, emergency contraceptives, and week of pregnancy.

Results: We identified 26,395 Bing users in the United States who queried about missing OC pills and the fraction that further queried about miscarriage, abortion, emergency contraceptive, and week of pregnancy. Users under the age of 30 years who asked about forgetting an OC dose were more likely to ask about abortion (1.5 times) and emergency contraception (1.7 times) (P<.001 for both), while users at ages of 30-34 years were more likely to query about pregnancy (2.1 times) and miscarriage (5.4 times) (P<.001 for both).

Conclusions: Our data indicate that many women missing a dose of OC might not have received sufficient information from their health care providers or chose to obtain it online. Queries about abortion and miscarriage peaking in the subsequent days indicate a common worry of possible pregnancy. These results reinforce the importance of providing comprehensive written information on missed pills when prescribing an OC.

Keywords: abortion; birth control; miscarriage; search engines.

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Conflict of interest statement

Conflicts of Interest: EYT is an employee of Microsoft, owner of the search engine Bing.

Figures

Figure 1
Figure 1
Percentage of users who asked about missed OC doses and then asked about miscarriage, pregnancy (as indicated by a query for the week of pregnancy), abortion, and emergency contraception as well as the percentage of users who asked about missed OC doses, followed by a query about miscarriage, abortion, or emergency contraceptive, before querying about the week of pregnancy.
Figure 2
Figure 2
Distribution of the number of days between queries for a missed OC dose and for miscarriage, abortion, and emergency contraceptive.
Figure 3
Figure 3
Number of users by age group who asked about missed OC doses and each of the other query categories.
See this image and copyright information in PMC

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References

    1. World Health Organization . Selected practice recommendations for contraceptive use. Second ed. Geneva: World Health Organization; 2004.
    1. Johnson S, Pion C, Jennings V. Current methods and attitudes of women towards contraception in Europe and America. Reprod Health. 2013 Feb 05;10(1):7. doi: 10.1186/1742-4755-10-7. https://reproductive-health-journal.biomedcentral.com/articles/10.1186/1... - DOI - DOI - PMC - PubMed
    1. Trussell J. Contraceptive failure in the United States. Contraception. 2004 Aug;70(2):89–96. doi: 10.1016/j.contraception.2004.03.009. - DOI - PubMed
    1. Dehlendorf C, Fox E, Sobel L, Borrero S. Patient-Centered Contraceptive Counseling: Evidence to Inform Practice. Curr Obstet Gynecol Rep. 2016 Jan 29;5(1):55–63. doi: 10.1007/s13669-016-0139-1. - DOI
    1. Rosenberg MJ, Waugh MS, Meehan TE. Use and misuse of oral contraceptives: risk indicators for poor pill taking and discontinuation. Contraception. 1995 May;51(5):283–8. doi: 10.1016/0010-7824(95)00074-k. https://linkinghub.elsevier.com/retrieve/pii/001078249500074K - DOI - PubMed

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