Continuation of prescribed vs over-the-counter oral contraceptives

January 01, 0001

Continuation of prescribed vs over-the-counter oral contraceptives

These US authors estimated differences in continuation of oral contraceptive pills (OCPs) between U.S. resident women obtaining pills in U.S. family planning clinics compared with over-the-counter in Mexican pharmacies. They recruited 514 OCP users in a border town who obtained pills over the counter from a Mexican pharmacy and 532 who obtained OCPs by prescription from a family planning clinic in El Paso. A baseline interview was followed by three consecutive surveys over 9 months. They asked about date of last supply, number of pill packs obtained, how long they planned to continue use, and experience of side effects. Retention was 90%, with only 105 women lost to follow-up.

They found: "In a multivariable Cox proportional hazards model, discontinuation was higher for women who obtained pills in El Paso clinics compared with those who obtained their pills without a prescription in Mexico (hazard ratio 1.6). Considering the number of pill packs dispensed to clinic users, discontinuation rates were higher (hazard ratio 1.8) for clinic users who received one to five pill packs. However, there was no difference in discontinuation between clinic users receiving six or more pill packs and users obtaining pills without a prescription."

The authors concluded: "Results suggest providing OCP users with more pill packs and removing the prescription requirement would lead to increased continuation."

The bottom line seems to be to make it easy for women to get their oral contraceptive pills.

For the full abstract, click here.

Obstet Gynecol 117(3):551-557, March 2011
© 2011 to the American College of Obstetricians and Gynecologists
Continuation of Prescribed Compared With Over-the-Counter Oral Contraceptives. Joseph E. Potter, Sarah McKinnon, Kristine Hopkins, et al. Correspondence to Dr. Potter: [email protected]

Category: W. Pregnancy, Family Planning. Keywords: oral contraception, over-the-counter, continuation, cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 3 May 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.