High-risk teen compliance with prescription contraception: an analysis of Ohio Medicaid claims.
OBJECTIVE
This study examines utilization of and compliance with prescription contraception by adolescents.


METHODS
Retrospective cohort analysis of billing and pharmacy claims.


METHODS
Ohio Medicaid fee-for-service enrollees.


METHODS
Claims data of 12- to 19-year-olds identified at high risk for pregnancy by sexually related service billing or procedure code.


METHODS
Prescription contraception use and compliance patterns were examined over a 12-month study period.


RESULTS
During a 6-month enrollment period, 3338 females were identified at risk for pregnancy. Over one-fourth (920) became pregnant. Across the 12-month follow-up, 40% (1328) used no prescription contraception and 33% (1090) used some prescribed contraceptive. Most teens used injectable medroxyprogesterone (517) or oral contraceptive pills (492). About 20% of those using any type of prescribed contraceptive were compliant for the full year; less than 30% used a method for 3 months or less. Whites were more compliant with contraception than nonwhites. Younger age and concurrent mental health condition were also predictors of noncompliance.


CONCLUSIONS
Teens at risk for pregnancy demonstrated poor compliance with prescribed contraceptives. Billing/pharmacy claims analysis is a useful tool for identifying teens at risk for pregnancy in order to target and evaluate interventions or to benchmark care provided to adolescents.
Zink
Therese M
TM
Department of Family Medicine, University of Cincinnati, Cincinnati, OH 45267-0582, USA. zinktm@fmmail.uc.edu
Shireman
Theresa I
TI
Ho
Mona
M
Buchanan
Thomas
T
D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003270:Contraceptive Agents / Q000600:supply & distribution* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008484:Medicaid; D009820:Ohio; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
D003270:Contraceptive Agents