Does the Use of Electronic Interactive Social Networking Increase the Compliance Rate in Adolescent First Time Oral Contraceptive Users?

Abstract

Background: Oral contraceptive pills (OCPs) are prescribed to adolescent girls for a variety of reasons and can provide relief for many gynecologic conditions and prevent unintended pregnancy. Research studies have highlighted high discontinuation rates in OCP users during the first few months. The objective of this study is to evaluate the effectiveness of an interactive social networking intervention on the compliance rate of firsttime adolescent oral contraceptive pill users. Methods: This prospective interventional study was approved by our Institutional Review Board. Patients between the ages of 13-21 presenting to our ambulatory center for gynecologic care and receiving a prescription of OCPs for the first time were offered enrollment. All participants possessed a cell phone with text messaging and photo capabilities. Nonpossession of a cell phone with texting and media capturing capabilities, previous OCP users and patients whom were actively pregnant were excluded. All eligible individuals agreed to participate. Participants received traditional verbal contraceptive counseling and chose a 21-day active pill or a three month extended cycle pill regimen. Participants chose to take their pill in the morning or in the evening. Pre and post intervention questionnaires were obtained documenting the participants perceived compliance rate. Participants were instructed to set a daily alarm on their phone to serve as a reminder and were registered for an online patient portal. A method for a three month follow up either in person, via telephone, or via the online portal was chosen. Daily text message reminders were sent Monday through Friday at either 0700 or 1645. The participants were prompted in the daily text messages to send a reply photo of their OCP pack. Although the number of participants enrolled in our study does not allow statistically significant comparison to historical controls regarding OCP compliance, several of our observational findings are reported. Results: To date, out of twenty participants, ten have completed the three month texting intervention. 51% of text messaging requests for photos of pill packs were returned. Frequency of text messaging was highest in weeks 1 and 8 (Fig, 1). Eight of the ten participants complied with a three month follow up. The rate of photo response was high in all participants who followed up after three months and low in the two patients that did not follow up. In the follow up group, patients recalled missing pills 3% of the time and all planned to continue use of an OCP. Based on photo responses, only two instances of missed pills were detected. Patients overwhelmingly preferred to follow up with text messaging in lieu of other methods. All incidences (3) of participant misuse errors were discovered via photo. All patients utilized interactive text messaging liberally for other concerns.