Adherence and Acceptability of the Contraceptive Ring Compared With the Pill Among Students

Gilliam, Melissa; Neustadt, Amy; Kozloski, Michael; Mistretta, Stephanie Q.; Tilmon, Sandra; Godfrey, Emily M.

doi:10.1097/aog.0b013e3181cf45dc

Cited by 65 publications

(25 citation statements)

References 10 publications

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“…The Population Council has now completed studies on the new CVR that releases NES 150 μg/day and EE 15 μg/day 69. NES is a potent non-androgenic P derivative that has not been used in any other contraceptive method.…”

Section: New Contraceptive Methods Recently Launched In Different Marmentioning

confidence: 99%

“…NES is a potent non-androgenic P derivative that has not been used in any other contraceptive method. The ring is a donut-shaped, silicone elastomer ring with a two-channel core containing the steroids, one channel releasing NES alone and the other channel releasing both NES and EE 69. Fewer bleeding problems were found with this combination and dose when compared to another CVR.…”

Section: New Contraceptive Methods Recently Launched In Different Marmentioning

confidence: 99%

See 1 more Smart Citation

New and emerging contraceptives: a state-of-the-art review

Bahamondes¹,

Bahamondes²

2014

IJWH

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BackgroundThe first hormonal contraceptive was introduced onto the market in several countries 50 years ago; however, the portfolio of contraceptive methods remains restricted with regards to their steroid composition, their cost, and their ability to satisfy the requirements of millions of women/couples in accordance with their different reproductive intentions, behaviors, cultures, and settings.MethodsA literature review was conducted using Medline, Embase, and Current Contents databases, up to September 1, 2013 to identify publications reporting new contraceptives in development using combinations of the search terms: contraception, contraceptives, oral contraceptives, patch, vaginal ring, implants, intrauterine contraceptives, and emergency contraception (EC). Also, several experts in the field were also consulted to document ongoing projects on contraception development. Additionally, the Clinicaltrial.gov website was searched for ongoing studies on existing contraceptive methods and new and emerging female contraceptives developed over the past 5 years. Information was also obtained from the pharmaceutical industry.ResultsEarly sexual debut and late menopause means that women may require contraception for up to 30 years. Although oral, injectable, vaginal, transdermal, subdermal, and intrauterine contraceptives are already available, new contraceptives have been developed in an attempt to reduce side effects and avoid early discontinuation, and to fulfill women’s different requirements. Research efforts are focused on replacing ethinyl-estradiol with natural estradiol to reduce thrombotic events. In addition, new, less androgenic progestins are being introduced and selective progesterone receptor modulators and new delivery systems are being used. In addition, research is being conducted into methods that offer dual protection (contraception and protection against human immunodeficiency virus transmission), and contraceptives for use “on demand.” Studies are also investigating non-hormonal contraceptive methods that have additional, non-contraceptive benefits.ConclusionThe most pressing need worldwide is, first, that the highly effective contraceptive methods already available should be affordable to most of the population and also that these methods should fulfill the needs of women of different ages and with different reproductive requirements. The development of new contraceptive methods should also take advantage of the knowledge obtained over the past 30 years on gamete physiology and gamete interaction to avoid the use of steroid compounds.

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Section: New Contraceptive Methods Recently Launched In Different Marmentioning

confidence: 99%

Section: New Contraceptive Methods Recently Launched In Different Marmentioning

confidence: 99%

New and emerging contraceptives: a state-of-the-art review

Bahamondes¹,

Bahamondes²

2014

IJWH

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“…IVR users were more likely to report perfect use compared with daily pill users 52. The IVRs that are currently in contraceptive, microbicide, or MPT development are being designed to have a 30–365 day duration 33…”

Section: Advantages Of Ivrs For Delivery Of Microbicides and Mptsmentioning

confidence: 99%

“…Though it remains to be seen whether IVRs will in fact improve adherence to microbicide use, a study comparing the adherence to contraceptive IVRs with adherence to daily oral contraceptive pills provides encouraging results 52. IVR users were more likely to report perfect use compared with daily pill users 52.…”

Section: Advantages Of Ivrs For Delivery Of Microbicides and Mptsmentioning

confidence: 99%

Intravaginal rings as delivery systems for microbicides and multipurpose prevention technologies

Thurman

Clark

Hurlburt³

et al. 2013

IJWH

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There is a renewed interest in delivering pharmaceutical products via intravaginal rings (IVRs). IVRs are flexible torus-shaped drug delivery systems that can be easily inserted and removed by the woman and that provide both sustained and controlled drug release, lasting for several weeks to several months. In terms of women’s health care products, it has been established that IVRs effectively deliver contraceptive steroids and steroids for the treatment of postmenopausal vaginal atrophy. A novel application for IVRs is the delivery of antiretroviral drugs for the prevention of human immunodeficiency virus (HIV) genital infection. Microbicides are antiviral drugs delivered topically for HIV prevention. Recent reviews of microbicide IVRs have focused on technologies in development and optimizing ring design. IVRs have several advantages, including the ability to deliver sustained drug doses for long periods of time while bypassing first pass metabolism in the gut. IVRs are discreet, woman-controlled, and do not require a trained provider for placement or fitting. Previous data support that women and their male sexual partners find IVRs highly acceptable. Multipurpose prevention technology (MPT) products provide protection against unintended/mistimed pregnancy and reproductive tract infections, including HIV. Several MPT IVRs are currently in development. Early clinical testing of new microbicide and MPT IVRs will require a focus on safety, pharmacokinetics and pharmacodynamics. Specifically, IVRs will have to deliver tissue concentrations of drugs that are pharmacodynamically active, do not cause mucosal alterations or inflammation, and do not change the resident microbiota. The emergence of resistance to antiretrovirals will need to be investigated. IVRs should not disrupt intercourse or have high rates of expulsion. Herein, we reviewed the microbicide and MPT IVRs currently in development, with a focus on the clinical aspects of IVR assessment and the challenges facing microbicide and MPT IVR product development, clinical testing, and implementation. The information in this review was drawn from PubMed searches and a recent microbicide/MPT product development workshop organized by CONRAD.

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“…Each method has observed some success, but each also depends on patient report and creates patient awareness of monitoring, both of which can bias results [13, 14]. Another tool, pharmacy claims data, provides an objective adherence measure that can be used across a wide range of specialties [15].…”

Section: Introductionmentioning

confidence: 99%

Understanding prescription adherence: pharmacy claims data from the Contraceptive CHOICE Project

et al. 2011

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BACKGROUND We examined prescription adherence rates by contraceptive method among women who used oral contraceptive pills (OCP), transdermal patch, or vaginal ring. STUDY DESIGN Women in the St. Louis area were provided their choice of OCP, patch, or ring at no cost and followed for 18 months. Time between monthly refills was obtained from pharmacy data and analyzed as a marker of adherence. Risk factors for initial nonadherence were estimated using Cox proportional hazards; predictors for repeated nonadherence were analyzed using Poisson regression with robust error variance. RESULTS Overall, 619 participants filled 6,435 contraceptive prescriptions with a median of 10 refills per participant. Only 30% of women (n=187) obtained all refills on time. In the time-to-failure analysis, use of vaginal ring and increased parity were predictors of early nonadherence (p<0.05). In the multivariable analysis, use of the vaginal ring and history of abortion were risk factors for repeated nonadherence (p<0.01). CONCLUSIONS Even with financial barriers removed, pharmacy data show that many women inconsistently refill their contraception and may be at risk for unintended pregnancy.

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Adherence and Acceptability of the Contraceptive Ring Compared With the Pill Among Students

Abstract: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00635570.

Cited by 65 publications

References 10 publications

New and emerging contraceptives: a state-of-the-art review

New and emerging contraceptives: a state-of-the-art review

Intravaginal rings as delivery systems for microbicides and multipurpose prevention technologies

Understanding prescription adherence: pharmacy claims data from the Contraceptive CHOICE Project

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