Altruism may be a strong motivator for contraceptive research participation among medically complex patients, and both patients and clinicians desire new efficacious, safe, low side effect contraceptives for patients at increased thrombosis risk.
Key Findings
Results
The majority of respondents participated in the study to help others, suggesting altruism as a strong motivator for contraceptive research participation among medically complex patients.
16 patients and 11 clinicians were interviewed from June 2020 to June 2022
Participants were recruited in New Mexico via telephone and Zoom
Some participants indicated they wanted to share their difficult experiences to bring awareness to the topic
Altruism was identified as a theme despite the sensitive nature of reproductive health discussions
Results
Most patient participants had more than one condition associated with increased thrombosis risk.
60% of patients had more than one qualifying condition
Conditions included hypertension, antiphospholipid antibody syndrome, history of cerebral vascular accident, deep vein thrombosis, pulmonary embolism or myocardial infarction, systemic lupus erythematosus, or a thrombophilia
16 patients of reproductive age were interviewed in total
The sample represented a medically complex patient population
Results
Virtual participation overcame several common barriers to research participation.
Interviews were conducted via telephone and Zoom
Virtual options addressed barriers including scheduling concerns, transportation, and finding childcare
Virtual participation was identified as likely improving both recruitment and retention
Discomfort with reproductive health was highlighted as a potential barrier that some participants overcame by wanting to share experiences
Results
Patients and clinicians identified the same priority research outcomes for contraceptive studies in high-thrombosis-risk populations.
Both groups cited effectiveness, safety, and side effects as priority outcomes
Both groups also cited developing more contraceptive method options as a priority
Clinician specialties represented included hematology, rheumatology, pulmonology, pharmacy, and women's health
11 clinicians were interviewed in total
Results
All participants expressed interest in receiving the results of the study in which they participated.
100% of respondents (both patients and clinicians) wanted to receive study results
This finding was identified as relevant to preferred dissemination methods
The study aimed to determine patients' and clinicians' preferred dissemination methods for study results
This was one of the three primary study aims addressed through the qualitative interviews
Results
Clinicians recommended constructing research teams that reflect participant demographics to improve representation of at-risk populations.
Clinicians anticipated that demographically reflective research teams may lead to better representation of at-risk populations in contraceptive research
This recommendation was offered in the context of recruitment and retention strategies
The study was conducted in New Mexico, a state with a diverse patient population
This theme emerged from semistructured interviews coded deductively using Dedoose qualitative coding software
Background
Large prospective contraceptive studies with primary data collection are needed to improve the evidence base for people at increased thrombosis risk.
The authors note that most progestin-only contraceptives are generally considered safe for most patients at increased arterial and venous thrombosis risk, but patients and clinicians may be wary based on limited studies
The formative qualitative study was designed to identify solutions for recruitment, retention, outcome prioritization, and dissemination for such future large prospective studies
The study used semistructured interviews as a formative methodology
Interviews were transcribed and coded deductively, with themes categorized based on study aims
What This Means
This research explores how to design better studies on contraceptive options for people who face a higher-than-average risk of dangerous blood clots. Many people with conditions like lupus, antiphospholipid antibody syndrome, a history of blood clots, or certain heart conditions have limited contraceptive options because not enough research has been done on what is safe and effective for them. To figure out how to run those larger studies successfully, the researchers interviewed 16 patients and 11 clinicians across various specialties in New Mexico about what would motivate participation, what outcomes matter most, and how results should be shared.
One of the most notable findings was that a desire to help others — altruism — appeared to be a powerful motivator for patients to join research studies, even on a topic as personal as contraception. Conducting interviews virtually (by phone or video call) helped remove common barriers like transportation difficulties, scheduling conflicts, and the need for childcare. Both patients and clinicians agreed on the most important things a study should measure: how well a contraceptive works, how safe it is, what side effects it causes, and whether new options can be developed. Every single participant said they would want to receive the results of any study they joined.
This research suggests that future large-scale contraceptive studies focused on people with clotting risks could improve recruitment and retention by offering virtual participation, appealing to participants' desire to help others in similar situations, and building research teams that reflect the demographics of the communities being studied. These insights could help researchers design studies that are more inclusive and representative, ultimately leading to better contraceptive guidance for a population that currently has very limited evidence-based options.
Sherpa M, Siegrist E, Myaskovsky L, Sussman A, Chong K, Trujillo V, et al.. (2026). Perspectives on Contraceptive Research for Individuals with Increased Thrombosis Risk: A Qualitative Exploration of Patients and Clinicians.. Southern medical journal. https://doi.org/10.14423/SMJ.0000000000001974