MD Advisor for Oral Contraceptives app is an algorithmic guide to contraceptive selection

Purpose of App Review

To explore the usability of the MD Advisor for Oral Contraceptives app as a means of use for family planning.

The app is available for the iPad and the iPhone.

It is not available for the Android.

Introduction

Some days I feel like a broken record–be it an annual exam, a return prenatal care visit, a postpartum visit, or an sexually transmitted disease check, I ask all of my patients one question: What are you using for birth control?

Everyone can use birth control, but not everyone can use every kind of birth control–so who should get what?  Also, if you are going to give the pill, which one should it be?

The MD Advisor for Oral Contraceptives app attempts to make the process of deciding more straightforward with an evidence-based algorithm. This review is from the viewpoint of an obstetric resident, involved in family planning and global/public health.

User Interface

References, guidelines, and portals for providers and patients are clearly visible on the home page. The layout of the app’s home screen can be a bit off-putting – what you see is what you get.

To get to the algorithm, you click on the Prescriber Only button. The app then leads you through up to 21 sections of algorithm questions. These range from screening for liver disease to questions about postpartum to desired effects. It covers most of the range of questions I ask myself about my patients, but not all–no questions on HIV.

Depending on how you answer a particular question, you may have other questions to answer.

Recommendations are provided according to the guidelines–once your input flags a guideline, a pop-up window gives you recommendations.

When you choose to learn more about the recommendation, the app simply takes you back to the guidelines section, which sites the appropriate reference – no additional discussion or direction is provided. You better be sure this is what you wanted, because you cannot go back to where you were before–you start navigating (but not re-entering) at the beginning.

Within the algorithm itself, you can navigate “back” and “next,” but not to the home screen.

I like the guidelines section, including its scroll function. Guidelines are given a number, a condition, and a guideline for that condition. A reference for that guideline rounds out each selection.

Evidence to support use

References do not include the newest United States Medical eligibility for contraceptive use, although the American Congress of Obstetricians and Gynecologists Practice Bulletin and World Health Organization medical eligibility criteria for contraceptive use are referenced–direct links to each provided.

References, though, also include a non-peer reviewed source–quoted for guidelines 41-57. There are many good peer-reviewed references, so I am not sure why this particular reference is included and not others.

Price

  • Free

Likes

  • Provides references
  • Straightforward screening questions
  • Comprehensiveness of questions
  • Organization of questions into body systems
  • Does not require patient identifiers
  • Inclusion of desired effects of options

Dislikes

  • References do not cite the World Health Organization’s Medical Eligibility Criteria
  • Layout of home screen and question presentation
  • Limited number of pills referenced
  • Inclusion of non-peer reviewed material in an “evidence-based” app
  • Lack of navigation screens to move between sections or between the home page and parts of the algorithm
  • Focus mainly on Watson and Ortho-McNeil brands oral contraceptives (focuses on name brands, rather than doses), no inclusion or attempt at detail of other hormonal or non hormonal options

Healthcare providers that would benefit from the app

  • Any health care provider involved in family planning prescription or counseling, especially those with less than daily use of these skills

Patients that may benefit from app

  • Those who want to learn what types of birth control may be best for their needs and medical problems

Conclusions

  • No thrills algorithm app, mostly evidence based, to guide selection of oral contraceptives based on patient characteristics
  • Not as helpful for those with daily experience in contraceptive counseling and provision
  • Straightforward screening tool that could be used in settings outside of the United States where oral contraceptives are available without prescription–good public health use
  • Good app for those learning about hormonal family planning options, screening for contraindications, or additional uses, but not to be used as an absolute guide

iMedicalApps recommended?

  • Conditional yes (minus the low tech, it is not a bad app). Had I happened upon this app at the beginning of residency, I would have found it very useful. Now that I know more about birth controls options, I do not see myself utilizing it as frequently.
  • It might be helpful for a more complicated patient or for those who do not have a similar training background or experience in family planning.

Rating: 2.9
1. User Interface – 2.  Limited navigation within app.  Little thought given to how the app appears
2. Multimedia usage – 1.5 Limited use of multimedia – no images provided.  Limited
3. Price – 5  Free is free
4. Real world applicability – 2, better for novices

Disclaimer:
This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your health care provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or health care provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your health care provider.

Author:

Kelli Barbour MD
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