TY - JOUR
T1 - Understanding prescription adherence
T2 - Pharmacy claims data from the Contraceptive CHOICE Project
AU - Pittman, Meredith E.
AU - Secura, Gina M.
AU - Allsworth, Jenifer E.
AU - Homco, Juell B.
AU - Madden, Tessa
AU - Peipert, Jeffrey F.
N1 - Funding Information:
Financial support: supported by an anonymous foundation . This research was also supported in part by a Midcareer Investigator Award in Women's Health Research ( K24 HD01298 ), by a Clinical and Translational Science Award ( UL1RR024992 ) and by Grant Number KL2RR024994 from the National Center for Research Resources (NCRR) , a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on NCRR is available at http://www.ncrr.nih.gov/ . Information on Re-engineering the Clinical Research Enterprise can be obtained from http://nihroadmap.nih.gov/clinicalresearch/overview-translational.asp .
PY - 2011/4
Y1 - 2011/4
N2 - Background: We examined prescription adherence rates by contraceptive method among women who used oral contraceptive pills (OCP), transdermal patch or vaginal ring. Study Design: Women in the St. Louis area were provided their choice of OCP, patch or ring at no cost and followed for 18 months. Time between monthly refills was obtained from pharmacy data and analyzed as a marker of adherence. Risk factors for initial nonadherence were estimated using Cox proportional hazards; predictors for repeated nonadherence were analyzed using Poisson regression with robust error variance. Results: Overall, 619 participants filled 6435 contraceptive prescriptions with a median of 10 refills per participant. Only 30% of women (n=187) obtained all refills on time. In the time-to-failure analysis, use of vaginal ring and increased parity were predictors of early nonadherence (p<.05). In the multivariable analysis, use of the vaginal ring and history of abortion were risk factors for repeated nonadherence (p<.01). Conclusions: Even with financial barriers removed, pharmacy data show that many women inconsistently refill their contraception and may be at risk for unintended pregnancy.
AB - Background: We examined prescription adherence rates by contraceptive method among women who used oral contraceptive pills (OCP), transdermal patch or vaginal ring. Study Design: Women in the St. Louis area were provided their choice of OCP, patch or ring at no cost and followed for 18 months. Time between monthly refills was obtained from pharmacy data and analyzed as a marker of adherence. Risk factors for initial nonadherence were estimated using Cox proportional hazards; predictors for repeated nonadherence were analyzed using Poisson regression with robust error variance. Results: Overall, 619 participants filled 6435 contraceptive prescriptions with a median of 10 refills per participant. Only 30% of women (n=187) obtained all refills on time. In the time-to-failure analysis, use of vaginal ring and increased parity were predictors of early nonadherence (p<.05). In the multivariable analysis, use of the vaginal ring and history of abortion were risk factors for repeated nonadherence (p<.01). Conclusions: Even with financial barriers removed, pharmacy data show that many women inconsistently refill their contraception and may be at risk for unintended pregnancy.
KW - Pharmacy claims data
KW - Prescription adherence
KW - Unintended pregnancy
KW - Vaginal ring
UR - https://www.scopus.com/pages/publications/79952575360
U2 - 10.1016/j.contraception.2010.08.003
DO - 10.1016/j.contraception.2010.08.003
M3 - Article
C2 - 21397092
AN - SCOPUS:79952575360
SN - 0010-7824
VL - 83
SP - 340
EP - 345
JO - Contraception
JF - Contraception
IS - 4
ER -