Contraception for Solid Organ Transplant Patients: Utilizing Social Media
Condition: Contraception; Contraception Behavior; Contraceptive Usage; Reproductive Health
Study type: Observational

Summary: 
      The purpose of this study is to use an electronic survey to explore Solid Organ Transplant
      patients' contraceptive knowledge and counseling. The results from this survey will be used
      to help identify awareness gaps to potentially develop targeted interventions for
      comprehensive education.
    

Detailed description: 
      According to data from the U.S. Organ Procurement and Transplantation Network, 10,804 women
      received organ transplants in 2011. Of these women, 3896 (36%) were between the ages of 18
      and 49. Women of reproductive age make up a significant part of the transplant recipient
      population, so pregnancy in these immunocompromised patients is a concern. The incidence of
      unwanted pregnancy (a subset of unintended pregnancies) among female kidney transplant
      recipients is 48%, while the national incidence is 25%. The American Society of
      Transplantation (AST) has come to a consensus that gestations in organ transplant patients be
      considered high risk and be managed by both transplant physicians and high-risk pregnancy
      specialists. Pregnancies after organ transplantation have a high incidence of low birth
      weight (less than 2.5 kg).

      The risks posed to the woman herself, her transplanted organ, and fetus underscore the
      importance of having health care providers counsel transplant patients on family planning,
      including return to fertility, contraceptive use, and when pregnancy can be safely
      considered. Specifically the fetus may be exposed to teratogenic immunosuppressive transplant
      medications and pregnancy increases the risk for rejection of the transplanted organ.
      Therefore it is important that women are thoroughly counseled regarding contraceptive
      effectiveness and safety. Health care providers have a large impact on the reproductive
      decisions that patients make. In a study done in transplant clinics across the nation, the
      majority of respondents based their decision on whether to become pregnant on the guidance of
      the individual transplant physician.

      Transplant specialists may not be comfortably providing family planning services directly to
      patients. The Center for Disease Control and Prevention's United States Medical Eligibility
      Criteria for Contraceptive Use has specific guidance on the safety of each contraceptive for
      women undergoing solid organ transplants. However, this guidance is based on limited safety
      data. This study aims to add to the literature available on this patient population although
      we are not assessing safety. In addition, this study will identify improvement opportunities
      to the care provided to transplant patients within our own Health System.

      This research study is a unique collaboration between the Departments of Pharmacy,
      Nephrology, and Reproductive Medicine.
    

Intervention name(s): Survey
Intervention type(s): Behavioral
Intervention description(s): Solid Organ Transplant patients will be recruited via social media. Co-investigators will reach out to the administrators of various social media networks to share information regarding the study with their networks on our behalf. Potential participants who are interested in participating, can then follow the link to the online survey tool, which includes the participant demographic information (age, ethnicity and highest level of education) and questionnaire. The questionnaire is 30 questions long and takes approximately 15 minutes to complete. This questionnaire will be a single, cross-sectional survey. No personal information will be documented on the questionnaire. All responses will be anonymous. Participants will be recruited for 6 months.
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Women 18-50 years, solid organ transplant in the last 5 years, and fluent in English.
      
Keywords: organ transplant