Factors associated with 12-month discontinuation among contraceptive pill, patch, and ring users. 2013

Jourdan E Stuart, and Gina M Secura, and Qiuhong Zhao, and Meredith E Pittman, and Jeffrey F Peipert
Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri.

OBJECTIVE To examine factors associated with discontinuation of the oral contraceptive pill (OCP), patch, and ring. METHODS We included 1,452 female participants from the Contraceptive CHOICE Project who selected the OCP, patch, or ring and completed 12 months of follow-up for this analysis. We defined discontinuation as stopping the contraceptive method for longer than 1 month during a follow-up survey. Participants who stopped their method as a result of pregnancy or to attempt pregnancy or who were lost to follow-up were censored. We examined demographic, behavioral, and method-related factors in the Cox proportional hazard models. RESULTS Patch users had a higher 1-year discontinuation rate (58%) than OCP (47%; P=.03) and ring users (49%; P=.02). Women were more likely to discontinue the OCP, patch, or ring if they were black (adjusted hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.02-1.44), no longer married (adjusted HR 1.83, 95% CI 1.27-2.65), or received public assistance (adjusted HR 1.30, 95% CI 1.08-1.57). Women who reported difficulty obtaining the method were more than twice as likely to discontinue (adjusted HR 2.43, 95% CI 1.81-3.27). Women who were certain they would continue despite side effects (adjusted HR 0.57, 95% CI 0.43-0.77) were less likely to discontinue. CONCLUSIONS Despite selecting their method and obtaining it at no cost, almost half of OCP and ring users and a majority of patch users discontinued their method by 12 months. Experiencing difficulty obtaining the method contributes to high rates of discontinuation. METHODS II.

UI MeSH Term Description Entries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D003274 Contraceptive Devices, Female Contraceptive devices used by females. Cervical Cap,Coiled Spring,Vaginal Diaphragm,Vaginal Rings,Vaginal Shield,Vaginal Sponge,Cap, Cervical,Caps, Cervical,Cervical Caps,Coiled Springs,Contraceptive Device, Female,Device, Female Contraceptive,Devices, Female Contraceptive,Diaphragm, Vaginal,Diaphragms, Vaginal,Female Contraceptive Device,Female Contraceptive Devices,Ring, Vaginal,Rings, Vaginal,Shield, Vaginal,Shields, Vaginal,Sponge, Vaginal,Sponges, Vaginal,Spring, Coiled,Springs, Coiled,Vaginal Diaphragms,Vaginal Ring,Vaginal Shields,Vaginal Sponges
D003276 Contraceptives, Oral Compounds, usually hormonal, taken orally in order to block ovulation and prevent the occurrence of pregnancy. The hormones are generally estrogen or progesterone or both. Low-Dose Oral Contraceptive,Oral Contraceptive,Oral Contraceptives,Oral Contraceptives, Low-Dose,Oral Contraceptives, Phasic,Contraceptive, Low-Dose Oral,Contraceptive, Oral,Contraceptives, Low-Dose Oral,Contraceptives, Phasic Oral,Low Dose Oral Contraceptive,Low-Dose Oral Contraceptives,Oral Contraceptive, Low-Dose,Oral Contraceptives, Low Dose,Phasic Oral Contraceptives
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D055118 Medication Adherence Voluntary cooperation of the patient in taking drugs or medicine as prescribed. This includes timing, dosage, and frequency. Drug Adherence,Drug Compliance,Medication Compliance,Medication Nonadherence,Medication Non-Adherence,Medication Non-Compliance,Medication Noncompliance,Medication Persistence,Adherence, Drug,Adherence, Medication,Compliance, Drug,Compliance, Medication,Medication Non Adherence,Medication Non Compliance,Non-Adherence, Medication,Non-Compliance, Medication,Nonadherence, Medication,Noncompliance, Medication,Persistence, Medication
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults
D057968 Transdermal Patch A medicated adhesive patch placed on the skin to deliver a specific dose of medication into the bloodstream. Patch, Transdermal,Patchs, Transdermal,Transdermal Patchs

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