As a full scope family medicine provider, I prescribe a variety of contraception to women from oral contraceptives pills to patches, IUDs, implants, and Depo-Provera. The process is relatively straight forward for most of these and current guidelines from the CDC and WHO can help guide practice.
Recent evidence has reaffirmed the safety of long acting reversible forms of contraception for women and adolescents.
One of the challenges that I run into, not uncommonly, in clinic is when should a patient on Depo receive their next dose? What do you do with the patient who is late for their dose? What is late anyways? I have seen clinic policies vary from 11 to as many as 15 weeks. What is the “right” answer? If a patient is turned away unnecessarily, they may return the next time pregnant. Now instead of contraceptive care, we now have to provide prenatal care.
There are a number of contraception apps available for providers to use at the point of care. Some of the ones we have reviewed favorably at iMedicalApps include the CDC Contraception app and Contraception Pocket-cards. However, neither of these apps provides an easy way for a provider to calculate when a patient is due for her next Depo dose. On a related note, I still strongly recommend the Managing Contraception pocketbook for everything you wanted to know about contraception including fantastic troubleshooting tips. However, there is no mobile version of this pocketbook.
Yet again, Dr Joshua Steinberg comes to the rescue! For years, I have used his many outstanding medical applications. He has just released two new apps, PneumoVaccines and Depo Calendar, which I will be reviewing this week. He has designed a variety of useful point of care apps including PreopEval14, PFT Eval, EFM Guide, PE & DVT Dx Tool, OB Wheels and my favorite, Pneumonia Guide. The content of the Depo Calendar app consists of a main screen with the date for a patient’s last Depo shot and today’s date. The app then lists the date a patient should receive Depo based on follow-up periods of 11 to 15 wks. The app includes an information icon that summarizes the current Pfizer reference for Depo, CDC recs, and some of the applicable literature on the topic. Additionally, Dr Steinberg includes his references for the app and a link to other medical apps he recommends (in addition to his own).
You are in clinic when your nurse comes to ask about a patient who has walked in for her Depo shot. The patient’s last Depo shot was 14 weeks ago. Can she receive her shot today? Does she need to use other forms of contraception? Should you obtain a pregnancy test? What does your clinic policy say about how late a patient can receive Depo? What if she came in at 10 weeks for her shot? Depo Calendar will help you with these decisions! Let’s take a look at Depo Calendar in action.
Evidence based medicine
Depo Calendar incorporates the most current guidelines from the drug manufacturer, CDC guidelines, and the most current evidence on Depo dosing intervals/safety. The app contains voluminous reference material to back its calculator functionality.
What providers would benefit from this App?
Students, residents, mid-levels, Family Medicine, OB-GYN, Midwives, Pharmacists, Nursing Staff and any provider who administers Depo-Provera.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
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