Online availability of hormonal contraceptives without a health care examination: effect of knowledge and health care screening

Background: The study was conducted to investigate whether the knowledge of women using an online resource to obtain hormonal contraceptives (HCs) without a health care examination is similar to women who obtain HC in the clinic. Study Design: Women who accessed HC prescriptions online or through a clinic visit were offered an anonymous self-administered survey regarding the contraindications to and possible complications of HC. Tests of equivalence were used to compare the mean scores between the two populations. Results: Online users (n=243) were older, more affluent, more educated, and more likely to be insured than clinic patients (n=161). The two populations demonstrated equivalent HC knowledge [contraindications (mean score, 95% confidence interval): clinic 81.1% (77.2-85.0%), online 85.0% (82.0-88.0%); complications: clinic 77.6% (72.7-82.6%), online 82.1% (78.8-85.5%)]. The online population remained equivalent or superior to the clinic population in an age-restricted analysis. Conclusion: Women who self-select to obtain HC prescriptions online demonstrate at least equivalent knowledge of potential HC risks as women seen in a clinic encounter without a pelvic examination.