Rationale: Oral contraceptives (OCs) are conventionally initiated during a woman's menses, which often means waiting weeks after prescription to take the first pill. Many women do not begin their OCs due to confusion, ambivalence or intervening pregnancy. Taking the first pill immediately and under direct observation is an alternative initiation method employed in the Columbia-Presbyterian Family Planning Clinics.
Purpose: This prospective observational study assessed continuation to the second pack of pills among women who took their first tablet in the clinic compared with women instructed to start the pill conventionally.
Methods: We interviewed 250 women requesting OCs for contraception at the end of their clinic visit regarding: OC instructions, contraceptive and reproductive history, fertility motivation, acculturation, and partner influence. A telephone interview, about six weeks after enrollment, used calendar recall to quantify pills taken.
Results: Participants were predominantly Hispanic; their mean age was 22. 229 women (92%) completed the follow-up interview. 88% of the women who took their first pill in the clinic continued to the second pack of pills, compared with only 74% of those who started the pill conventionally (p=0.03).
Also associated with continuation were age, partner knowledge of OC use and desire for pregnancy. After adjustment, women who took their first pill in the clinic remained more likely to continue (OR 2.74; 95% CI 1.1; 6.8) than women who did not.
Conclusion: This approach simplifies health education, is easy to implement, and may lead to increased OC continuation, but needs to be evaluated in a randomized trial.
Learning Objectives: At the end of this presentation, the participant will be able to: 1. Recognize patient characteristics associated with oral contraceptive continuation; 2. Apply a new method of oral contraceptive initiation; and 3. Change message priorities in contraceptive health education.
Keywords: Contraception, Counseling
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.