Assessment of oral contraceptive pill continuation in young women

Abstract

Study Objective: To assess oral contraceptive pill (OCP) continuation rates and factors associated with OCP continuation in young women. Design: A 12-month retrospective cohort study by chart review of 226 young women seen for an initial clinic visit. Setting: Urban hospital-based family planning clinic. Participants: Predominantly African-American, sexually active young women, 12 to 21 years of age (median age, 17.2 years). Main Outcome Measures: Scheduled OCP-appointmentkeeping rates, pregnancy rates, and associated factors were compared between OCP-compliant and -noncompliant groups. Results: The OCP-appointment-keeping rate declined dramatically over 1 year, from 29% at the 3-month visit to 9% at the 12-month visit. Almost half seeking a postpartum visit checkup (PPVup) did not return after the initial clinic visit. Overall, a higher OCP-appointment-keeping rate was noted in those seeking OCPs vs. PPVup at the initial visit; P < .05 for 12-month visit. There was no difference in the pregnancy rates between OCP-compliant and -noncompliant groups. School enrollment and nulliparity was significantly associated with OCP compliance until the 6-month visit ( P < .05). Conclusions: In an urban hospital based clinic, the OCP continuation rate after the initial visit was poor. Continuation of OCPs may be anticipated by type of services sought at an initial visit. Methods to improve OCP continuation in this setting should be implemented.