مقايسه تداوم استفاده از دپوپروورا و سيكلوفم ودلايل عدم تداوم آنها در خانه هاي بهداشت استان آذربايجان شرقي 1388

Comparison of Continuation Rates and Reasons for Discontinuation of Cyclofem and Depo- Provera in Health Houses of East Azarbaijan, Iran, 2009

Background& Objectives:Depo-provera and cyclofem are the only available injection methods used by 2.6% of internal groups of women of Iran. Cyclofem has been provided by the public health system since 2007. However there is no study on continuances of this method in Iran; all of the studies on DMPA published in Iran have been conducted in urban areas. The aim of this study is to compare continuation rate and reasons for discontinuation of Depo-provera and cyclofem in health houses of East Azarbaijan. Materials & Methods: A retrospective cohort study was conducted on 422 women who had started using cyclofem (202 women) or Depo-provera (220 women) within 12-24 months prior to data collection. Data were gathered by a questionnaire which was completed by interview with individuals and were analyzed by SPSS/ using Kaplan Mayer and chi-square tests. Result: The mean age of participants was 33 year(SD=7). 10% of participants had secondary education or higher. 92.5% were housewives. Continuation rate for Cyclofem during first 24 months was significantly less than Depo-provera (P<0.001). continuation rate of the 3, 6, 9, 12 monthes use of cyclofem were 56%, 37%, 30%, 27% versus 75%, 59.5%, 48%, 42.5% for Depo-provera. The most common reasons for discontinuation in the both groups were menstural changes as a combined reason (85% for Depo-provera versus 72%) for cyclofem,P=0.008) and amenorrehea as a individual reason (50% versus 22%, P<0.001). Conclusion: Continuation rate of cyclofem was significantly lower than Depo-provera (P<0.001). The main reason for discontinuation of the methods in both of these groups was menstrual changes especially amenorrhea or menstruation spotting which have no life-threating side effects. Regarding this case and low relative continuity of these methods (compared with studies conducted in other countries) health providers can help to improve continuation rate by appropriate consultation education of women.