DescriptionPurpose of Project: Depot medroxyprogesterone acetate 104mg subcutaneous (DMPA-SC) is a highly effective injectable form of contraception, which can be safely self-injected at home with high continuation and satisfaction rates. In October 2020, an urban family planning clinic in New Jersey implemented a self-administration pilot program. This quality improvement project was to evaluate the DMPA-SC self-administration pilot program and provide recommendations to disseminate a self-administration option across family planning healthcare settings.
Methodology: Feedback questionnaires on the feasibility and acceptability of the pilot program were distributed to patients enrolled in the pilot program and health center staff. A retrospective chart review of individuals who initiated DMPA-SC in-clinic in October 2020 was used to compare continuation rates with the self-administration group and a cost analysis of a self-administration program was conducted.
Results: The self-administration program had high satisfaction scores among the patient feedback group. 100% of patients surveyed successfully self-injected and would recommend self-administration to a friend. Staff responses demonstrated self-administration would improve workflow (66.67%). The self-administration group continued DMPA-SC at the same rate (x = 2.33, SD = .58) as the in-clinic administration group (x = 2.33, SD = 1.23), mean (0.0) not statistically significant (t = 0.0 [16]; p = 0.5) (95% confidence: -1.57 and 1.12). Self-administration can potentially be cost effective (13.26% cost savings and 8.61% cost benefit).
Implications for Practice: Having a self-administration option would have a profound impact on women’s health by increasing contraceptive access, adherence, and convenience and would increase staff satisfaction and workflow.