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Factors associated with 12-month discontinuation among contraceptive pill, patch, and ring users.
MedLine Citation:
PMID:  23344283     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
CONCLUSION: : 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.
LEVEL OF EVIDENCE: : II.
Authors:
Jourdan E Stuart; Gina M Secura; Qiuhong Zhao; Meredith E Pittman; Jeffrey F Peipert
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  121     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  330-6     Citation Subset:  AIM; IM    
Affiliation:
Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
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