Addressing Reproductive Health in Hospitalized Adolescents-A Missed Opportunity. J Adolesc Health 2019 Jun;64(6):721-724
Date
03/18/2019Pubmed ID
30878183DOI
10.1016/j.jadohealth.2019.01.005Scopus ID
2-s2.0-85062709346 (requires institutional sign-in at Scopus site) 17 CitationsAbstract
PURPOSE: Adolescents are at high risk for sexually transmitted infections (STIs) and pregnancy. Since many adolescents have poor access to preventive care, hospitalizations present a critical opportunity to address adolescents' reproductive health. The purpose of this study was to assess provision of reproductive health services within a hospital setting.
METHODS: Retrospective study of a consecutive sample of adolescent patients aged 13 years and older hospitalized on the hospitalist service at a large academic pediatric tertiary care center. Measures included sexual history documentation, pregnancy and STI testing, Human papillomavirus immunization status and administration, and provision of contraception.
RESULTS: Only 55% of 150 patients had sexual history documentation, and of those, 47% endorsed sexual activity. Associations with increased likelihood of sexual history documentation included female patients (67% vs. 36%, p < .01), hospitalizations for ingestion (71% vs. 48%, p < .01), hospitalizations to hospital medicine compared with critical care (59% vs. 14%, p < .01), and admission note written by an intern compared with a senior resident, advanced practice provider, or fellow (67% vs. 44%, 29%, 13%, p < .01). Eighteen patients (12%) were tested for STIs. Only 19% of patients due for human papillomavirus immunization received it. Sixty percent of females received a pregnancy test. Contraception was provided in two encounters (2% of females).
CONCLUSIONS: Results demonstrate a substantial missed opportunity to provide reproductive health services to hospitalized adolescents. Providers in hospital settings should optimize the opportunity to screen for sexual activity and reproductive health needs, provide indicated services, and offer education regarding reproductive health to hospitalized adolescents.
Author List
McFadden V, Schmitz A, Porada K, Mehta S, Stephany A, Pickett MAuthors
Vanessa Mcfadden MD Associate Professor in the Pediatrics department at Medical College of WisconsinMichelle L. Pickett MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdolescent, Hospitalized
Contraception
Female
Hospitals, Pediatric
Humans
Immunization Schedule
Male
Mass Screening
Papillomavirus Vaccines
Pregnancy
Pregnancy in Adolescence
Reproductive Health
Reproductive Health Services
Retrospective Studies
Sexual Behavior
Sexually Transmitted Diseases
