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Impact of 12-Month Contraceptive Pill Prescriptions on Usage and Continuation
Introduction to 12-Month Contraceptive Prescriptions
The practice of prescribing a 12-month supply of contraceptive pills, patches, and rings has been shown to significantly impact the continuation and adherence rates among users. This article synthesizes findings from multiple studies to understand the effects of such prescriptions on contraceptive use and overall health outcomes.
Increase in 12-Month Contraceptive Prescriptions
A study evaluating the impact of changing the default electronic medical record (EMR) settings to a 12-month supply for contraceptive pills, patches, and rings found a substantial increase in 12-month prescriptions. Before the change, only 10.7% of prescriptions were for a 12-month supply, which increased to 27.2% after the change (p<0.001). This increase was observed across various types of contraceptives, including pills, patches, and rings, and among different provider types and locations.
Continuation and Consistent Use of Contraceptive Pills
A systematic review examined whether the number of oral contraceptive pill packs dispensed affects method continuation and other measures of use. The review found that dispensing a greater number of pill packs (e.g., 12 packs) was associated with increased method continuation, fewer pregnancy tests, fewer pregnancies, and lower costs per client. However, it also noted an increase in pill wastage with larger quantities dispensed.
Adherence to Contraceptive Regimens
The adherence to contraceptive regimens can be influenced by the frequency of pill intake. A study on the desogestrel-only pill (Cerazette) demonstrated that ovulation inhibition was maintained even with 12-hour delays in tablet intake, indicating high efficacy and reliability of the pill. This suggests that even with minor delays, the contraceptive effectiveness remains uncompromised, which can encourage consistent use among women.
Biochemical Effects of Long-Term Contraceptive Use
Biochemical studies on a once-a-month contraceptive pill containing quinestrol and quingestanol acetate over 24 months showed significant changes in serum lipids, including triglycerides, free fatty acids, phospholipids, and cholesterol. These changes were similar to those observed in women taking daily combination pills, although the drop-out rate was high after 12 pills, indicating issues with long-term acceptability.
Conclusion
The shift to prescribing a 12-month supply of contraceptive pills, patches, and rings has been shown to increase adherence and continuation rates significantly. While there are biochemical changes associated with long-term use, the overall benefits in terms of reduced pregnancy rates and improved method continuation make it a viable strategy for enhancing contraceptive use. Further research is needed to address potential barriers and optimize the prescription practices for better health outcomes.
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