Measuring Compliance Among Oral Contraceptive Users

Abstract

Irregular use of the pill compromises the effectiveness of this highly reliable method. The consistency of pill-taking has traditionally been estimated through women's own reports of their patterns of pill use. In this study, self-reported data on pill-taking were compared with data from an electronic device measuring compliance among 103 women attending university health services and publicly funded family planning clinics. In three months of pill use, the electronic and self-reported data agreed on the number of days when pills were missed only 45% of the time; the level of agreement dropped from 55% in the first month to 38% in the third month. In each month, the proportion of women reporting no missed pills was much higher than the proportion recorded electronically (53-59% compared with 19-33%), and the proportion missing at least three pills according to the electronic data was triple that derived from the women's reports (30-51% vs. 10-14%). In addition, the electronic data recorded substantially more episodes in which women missed pills on two or more consecutive days (88 vs. 30).

Patterns of Oral Contraceptive Pill-taking and Condom Use among Adolescent Contraceptive Pill Users

“…Previous studies show that 50% of young women report imperfect pill use during a pill cycle [11,28]. Approximately 25% of OCP users miss two or more pills during a pill cycle, placing them at increased pregnancy risk [12,29].…”

“…In fact, many participants who identified themselves as OCP users were in method transition, associated with less consistent pill-taking and condom use. Thus, earlier research with less-well-specified identification of OCP method use may overestimate the degree of protection among adolescent OCP users [11,12,17,28,29]. However, it does appear that the stable OCP method use group is slightly more likely to cover coital events with condoms, although the extent to which condoms were utilized correctly was not specifically investigated.…”

“…Up to 60% of adult users report missed pill doses and up to 50% miss enough doses to place them at risk for pregnancy [11,12]. Therefore, clinicians must be aware that actual OCP usage differs from the ideal with associated perfect pill usage.…”

“…Along with retrospective patient reports, compliance has been monitored among adults with the use of electronic monitoring devices [11,12]. Therefore, there is a gap in the literature as we are unaware of the daily pattern, or patterns, of pill usage among adolescents.…”

Termination of pregnancy and the over 30s: what are trends in contraception use 1996 - 2006?

“…Women may use more than one type of contraceptive, Overall, our research found that the majority of women over 30 years of age used contraception at the time of conception in relation to a termination of pregnancy at the health service in South Australia. However, previous research in the USA found overreporting of compliance with contraceptive regimes by some women (Potter 1996).…”