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. 2025 Mar 3;15(3):e084735.
doi: 10.1136/bmjopen-2024-084735.

Awareness of risk when prescribing and taking combined hormonal contraceptives (CHCs): a qualitative study with women and health professionals in three European countries

Paula Cristina Gomes Alves  1 , Irene Petersen  2   3 , Iveta Nagyova  4   5 , Zuzana Katreniaková  4   5 , Vera Ehrenstein  3   6 , Fiona A Stevenson  2
Affiliations

Awareness of risk when prescribing and taking combined hormonal contraceptives (CHCs): a qualitative study with women and health professionals in three European countries

Paula Cristina Gomes Alves et al. BMJ Open. .

Abstract

Objectives: To explore the experiences of women and health professionals when communicating about combined hormonal contraceptives (CHCs), with a focus on venous thromboembolism (VTE). We also focused on information sources consulted by women for their decision-making process regarding contraceptives.

Design: Qualitative semistructured face-to-face interviews were conducted with 24 women and 16 health professionals. The study followed a phenomenological approach, and data were synthesised using the framework analysis method.

Setting: Community health centres across three countries in the UK, Denmark, and Slovakia.

Participants: Adult (aged 18+) women using CHC and health professionals eligible to prescribe CHC in their respective countries.

Results: Women tended to be positive about CHC's safety and seek information about CHC through their health professionals, family and friends. They would like to receive further information from health professionals, particularly when it comes to risks of CHC and alternative methods of contraception. Health professionals reported using a variety of methods to communicate about CHC and generally report giving advice based on national and local guidelines. In line with women's perspectives, they reported time constraints and lack of resources as barriers to communication about CHC. Health professionals in our sample believed there is a lack of standardisation in the information offered and guidelines used to prescribe CHC, with little contact with international regulators such as the European Medicines Agency.

Conclusions: It is necessary to improve the conditions under which contraceptive counselling is provided, as well as supporting health professionals in this task. Exploring the lived experiences of women and health professionals about how they discuss contraception choices can shed light on the best approaches to improve reproductive health consultations.

Keywords: Clinical Decision-Making; Health Literacy; Primary Healthcare; QUALITATIVE RESEARCH; Reproductive medicine; SEXUAL MEDICINE.

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Conflict of interest statement

Competing interests: None declared.

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