Effect of a mobile application-delivered educational video on interest in and uptake of contraception among patients with systemic lupus erythematosus in Thailand: A randomized controlled trial.

OBJECTIVE

To evaluate the impact of contraceptive education delivered via the mobile application (LINE) compared with in-person counseling among women with systemic lupus erythematosus (SLE).

STUDY

DESIGN

In this randomized controlled trial at a university hospital in Thailand, 156 sexually active women with SLE aged 18-45 were randomized to LINE-based video education (intervention) or standard in-person counseling (control). Intervention participants were referred for same-day initiation of desired contraceptives, while controls received them immediately. The primary outcome was the contraceptive method selected immediately after the session, categorized by effectiveness. Secondary outcomes included contraceptive knowledge, attitudes, and method use at four weeks.

RESULTS

Immediately after the intervention, intention to use long-acting reversible contraception (LARC) and any effective method was higher in the LINE group than in the control group (RR 1.58, 95% CI 1.08-2.30; and RR 1.36, 95% CI 1.01-1.83, respectively). However, at four weeks, actual LARC uptake and overall effective contraceptive use were lower in the LINE group (RR 0.59, 95% CI 0.38-0.91; and RR 0.66, 95% CI 0.47-0.92, respectively), largely due to non-attendance at health facilities to obtain the chosen methods. Knowledge scores improved in both groups. Fear of side effects remained the most frequently reported barrier.

CONCLUSION

Both LINE-based and face-to-face counseling improved contraceptive knowledge among women with SLE. LINE-based counseling enhanced intention but was less successful in translating intention into actual use, whereas in-person counseling with immediate method provision more effectively facilitated uptake of effective contraception.

IMPLICATION: Mobile interventions may be a useful adjunct to increase contraceptive intention among women with SLE, but additional support is needed to ensure translation into actual uptake.