COMPLIANCE AND ORAL-CONTRACEPTIVES - A REVIEW

Compliance difficulties are more common among oral contraceptive (OC) users than generally appreciated by clinicians, in part because uninte nded pregnancy is a relatively infrequent consequence and in part beca use more common manifestations such as spotting and bleeding may not b e recognized as resulting from poor compliance. While improving compli ance is a shared responsibility of patients, clinicians, and manufactu rers, the clinician is the focal point for these efforts. Counseling m ust be individualized, which requires knowledge of factors that predic t compliance and an understanding of the patient's decision-making pro cess as it relates to medications. Most OC compliance research has foc used on adolescents, where predictors of poor compliance include multi ple sex partners, low evaluation of personal health, degree of concern about pregnancy, and previous abortion. Good compliance has been link ed with patient satisfaction with the clinician, the absence of certai n side effects, establishing a regular daily routine to take OCs, and reading information distributed with OC packaging.