Acceptability and compliance with contraceptives
Dharani Hapangama , Clinical Lecturer / Dep. Of Gynaecology, University of Liverpool,UK
According to the best guess of demographers, at least 2.5 billion women will require contraception by the year 2025. Since we are in the era of the largest cohort of reproductive aged population in history, consequences of even a small difference in unwanted fertility will be catastrophic.Although the steroid hormonal regimens dominated the female methods of reversible contraceptives over the last 40 years, side effects have severely affected their acceptability (consent to receive / approval). This provides the incentive for the pursuit of novel alternative methods of contraception.
In 1995 Rosenburg and colleagues estimated $2.6 billion as the cost associated with unintended pregnancies that occurred due to poor compliance with the oral contraceptive pill. Non-adherence to a contraceptive method interferes with its efficacy and disrupts the evaluation of results in a research setting. Although compliance is a fundamental prerequisite for achieving the full potential efficacy of contraceptives, there is a dearth of information available on patient non-compliance with the use of different contraceptive methods. If at all, very little progress is made in either accurately detecting, or predicting non-compliance. We sought to obtain insight into the adherence behaviour of women taking part in a contraceptive trial assessing the feasibility of administering once a month mifepristone. The results demonstrate that we as clinicians and as clinical researchers have no other option but to work towards forming a true therapeutic alliance with our volunteers; and to come to an agreement with our patients rather than to impose a prescription or a protocol upon them.