Daily context matters: predictors of missed oral contraceptive pills among college and graduate students.
OBJECTIVE
The purpose of this study was to understand the relationship between daily contextual factors and oral contraceptive (OC) adherence among students who attend college or graduate school.


METHODS
Data on OC adherence, demographics, contextual factors, and side-effects were collected as part of the acceptability of the NuvaRing (Merck & Co, Whitehouse Station, NJ) vs OC study, in which students were assigned randomly to the contraceptive vaginal ring or to a low-dose OC. We performed bivariate and multivariable analyses to create an explanatory model for nonperfect OC adherence (missed at least 1 pill during 3 months of use).


RESULTS
In a multivariable predictive model, missing a pill was associated positively with high perceived stress (odds ratio [OR], 3.16; P = .007), having ≥10 hours per week of paid employment (OR, 2.13; P = .075), and living with a partner (OR, 9.92; P = .040).


CONCLUSIONS
Stressful and hectic lives contribute to poor OC adherence. When counseling women about contraception, clinicians should consider the influence of daily life on contraceptive adherence.
Hughey
Andrew B
AB
Pritzker School of Medicine, The University of Chicago, Chicago, IL 60637, USA.
Neustadt
Amy B
AB
Mistretta
Stephanie Q
SQ
Tilmon
Sandra J
SJ
Gilliam
Melissa L
ML
D000293:Adolescent; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D004651:Employment; D005260:Female; D006801:Humans; D055118:Medication Adherence; D015999:Multivariate Analysis; D012111:Residence Characteristics; D013315:Stress, Psychological / Q000453:epidemiology; D013334:Students; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult
D003276:Contraceptives, Oral