Table 1.

Studies that assess the effect of a follow-up visit or contact on contraceptive continuation or correct use

Author, year/country	Sources of support	Study design	Population	Outcome	Results					Strengths	Weaknesses	Grade
Neuteboom et al., 2003[4] Netherlands	None stated	Prospective cohort study	280 women who had IUD insertions at a medical center between January 1981 and April 2002 Group A: 199 women who had an IUD inserted with a follow-up schedule of 6 wks and 3, 6 and 12 mo, and annually thereafter Group B: 81 women who had an IUD inserted with a follow-up schedule of 6 wk and annually	Discontinuation for medical reasons within the first 12 mo Unnoticed expulsions	Number of women who discontinued and length of time prior to discontinuation for medical reasons within the first 12 mo after insertion.					Multiple follow-up schedules assessed Unnoticed expulsions measured	Used medical records and sampled women over a long period of time A greater proportion of women in group B used a levonorgestrel IUD than group A Completeness of medical records not described One center	II-2, poor
						N (%)*	Mean**	95% CI
					Group A	26 (14%)	6.9	5.3–8.6
					Group B	18 (24%)	2.1	0.7–3.5
					Total	44	5.0	3.6–6.3
					* RR 0.6; 95% CI 0.3–1.0. ** p <.05. 2 women, both in group B, did not notice the expulsion of their IUD. Their expulsion was detected during a standard follow-up visit at, respectively, 6 wk and 13 mo after insertion of the IUD. Overall risk of an unnoticed expulsion was 0.27 per 100 women-years (95% CI 0.02–0.8).
Bang, 1971[3] Korea	None stated	Controlled trial No specific follow-up schedule to determine IUD removal or expulsion was described, 91% of women were followed up either at the clinic or at home	175 women who were asked to return 1 wk after IUD insertion 126 women who were asked to return 2 wks after IUD insertion 190 women who were asked to return 1 mo after insertion All insertions occurred between February and June 1967	Removal, expulsion	Percent of removals and expulsions in each group before July 15, 1967					Multiple follow-up schedules assessed	Some women followed up in clinic (39%), and other women were followed up at home by a health worker (52%) Women-years contributed by each woman varied greatly	II-2, poor
						1 wk	2 wk	1 mo
					Group
					Removal	19.4	15.7	12.9
					Continuation	73.8	75.9	83.5
					Expulsions	4.5	4.8	2.0
Herceg-Baron et al., 1986[6] USA	None stated	Randomized controlled trial Interview was conducted at the first clinic visit, and 2 follow-up phone interviews occurred at 6 and 18 mo	469 adolescent females aged 12–17 years assigned to 4 different groups 83 adolescent females in the eriodic support group who received 2–6 phone calls (mean of 2.6 calls) from study staff 4–6 wk after initial clinic visit Control A: 201 adolescent females who completed the same three interviews as the intervention groups Control B: 61 adolescent females who only had third interview	Consistency of contraceptive use (always, sometimes, rarely/never) Pregnancy	Percent of adolescents reporting that they used contraception over the study period as assessed at 6 and 15 moa					Adolescents were randomized to treatment groups 84% of those agreeing to participate in the periodic support group were successfully followed up Multiple clinics	Data not assessed using intent to treat analysis Impact of calls on use was not stratified by method type	I, poor
					Group	Always	Sometimes	Rarely/never
						N (%)b	N (%)b	N (%)b
					Periodic support	22 (40.7)	9 (16.7)	23 (42.6)
					Control A	68 (47.6)	36 (25.2)	39 (27.3)
					aAmong adolescents who were sexually active at some time during follow-up and who provided complete contraceptive histories at both 6 and 15 mo bAuthors report that none of the differences were statistically significant, but results of statistical tests were not reported.
					Percent of adolescents who became pregnant during the 15 mo following the initial clinic visit
					Group	N		%
					Periodic support	65		11
					Contacted	53		6
					Not contacted	12		29
					Control A	166		14
					Control B	53		9
Kirby et al., 2010[5] USA	William and Flora Hewlett Foundation	Randomized controlled trial Follow-up telephone calls at 6, 12 and 18 mo	805 adolescent females between 14–18 years who visited the clinic between July 2005 and August 2007 Group 1: 402 adolescent females who received study intervention (follow-up calls from counselors who were trained on family planning methods, adolescent risk behavior and counseling techniques): 1 call per mo for 6 mo and bimonthly calls for 6 mo Group 2: 403 adolescent females in a control group	Condom use Hormonal contraceptive use	Percent of condom and hormonal contraceptive use at last sex					Authors conducted power calculation 78% completed the 6-mo follow-up survey, 74% completed the 12-mo survey, and 75% completed the 18-mo survey	Counselors only completed 30% of the 9 scheduled calls. Only 11% of intervention group participants received 6 or more completed calls. Single clinic	I, poor
						6 mo		12 mo
						Group 1	Group 2	Group 1	Group 2
					Percent used condom at last sex	53	60	55	57
					Percent used hormonal contraceptive at last sex	44	44	43	43
							18 mo
							Group 1		Group 2
					Percent used condom at last sex		58		55
					Percent used hormonal contraceptive at last sex		43		42
					Differences between intervention and control group were not statistically significant at any time point. The authors report that the intervention did not have any effect on pregnancy and that 25% of women in the total sample became pregnant.

Abbreviations: wks=week; mo=month; OR=odds ratio.