title: Attitudes, awareness, compliance and preferences among hormonal contraception users: a global, cross-sectional, self-administered, online survey.
abstract: BACKGROUND
  Healthcare professionals have a responsibility to help each woman select the most appropriate hormonal contraceptive according to her personal preferences, needs and circumstances.
  
  
  OBJECTIVE
  To assess attitudes, awareness, compliance and preferences of hormonal contraceptive users.
  
  
  METHODS
  A cross-sectional survey conducted through self-administered, online questionnaires. One questionnaire was administered in the US and another was administered in the UK, France, Germany, Spain, Italy, Brazil, Australia and Russia (Eight-Country Survey questionnaire).
  
  
  METHODS
  Current hormonal contraceptive users, aged 18-44 years, in the general community.
  
  
  RESULTS
  Questionnaires were completed by 5120 women. The mean age of the respondents was approximately 31 years and over 70% were current contraceptive pill users. Many women did not plan on having children in the next 3 years (range 44% in Russia to 77% in the US and UK), but a quick return of fertility upon contraceptive discontinuation was desired by the majority of women in all countries (range 54% in the US to 91% in Russia). Rates of discontinuation or switching to a different hormonal contraceptive in the past year ranged from 30% in Germany to 81% in Brazil. Requests to switch because of side effects ranged from 24% in Spain to 57% in Brazil. Results from the Eight-Country Survey questionnaire indicated that 42% of women would consider using one of the most effective contraceptive methods even if their menstrual cycle changed, 58% would accept irregular bleeding initially if they had fewer periods over time, 53% did not want/had concerns about foreign/additional estrogen in their body, 85% would prefer a monthly option with a lower hormone dose over a daily pill, 80% would consider switching contraceptives to minimize estrogen exposure and 74% would prefer an estrogen-free/progestin (progesterone congener)-only pill to avoid potential side effects from foreign/extra estrogen. Oral contraceptive users across all countries admitted missing (range 39% in the UK to 65% in Brazil) or taking a pill at the wrong time (range 12% in Spain to 67% in Brazil) in the previous 3 months. Approximately 81% of all respondents said they would consider using a method that did not require daily, weekly or monthly dosing. The proportion of women believing themselves well informed about their contraception options ranged from 30% in Russia to 86% in the US. Informed women were generally more aware of alternative methods than their uninformed counterparts. Responses also varied significantly among women in different age groups.
  
  
  CONCLUSIONS
  These findings demonstrate that a range of factors influence a woman's choice of contraceptive. This highlights the importance of individualized counselling during contraceptive selection to ensure that the option recommended is tailored to the personal preferences of each woman to improve compliance, continuance and prevention of an unwanted pregnancy.
authors.affiliation: Global Market Research, Schering Corporation, a Division of Merck & Co., Kenilworth, New Jersey 07033-0530, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hooper
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D001364:Awareness; D001938:Brazil; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004304:Dosage Forms; D004334:Drug Administration Schedule; D005060:Europe; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D055118:Medication Adherence; D057240:Patient Preference; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States; D016387:Women's Health; D014932:Women's Health Services; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal; D004304:Dosage Forms
references.citation: Am J Obstet Gynecol. 1999 Feb;180(2 Pt 2):276-9
references.pmid: 9988830
references.citation: Contraception. 1999 May;59(5):277-86
references.pmid: 10494480
references.citation: Perspect Sex Reprod Health. 2008 Jun;40(2):94-104
references.pmid: 18577142
references.citation: Fam Plann Perspect. 1999 Mar-Apr;31(2):56-63
references.pmid: 10224543
references.citation: Paediatr Perinat Epidemiol. 2008 Mar;22(2):195-200
references.pmid: 18298695
references.citation: Fam Plann Perspect. 1998 Sep-Oct;30(5):223-30
references.pmid: 9782045
references.citation: Contraception. 2008 Apr;77(4):276-82
references.pmid: 18342651
references.citation: Matern Child Health J. 2010 Mar;14(2):227-34
references.pmid: 19152103
references.citation: Eur J Contracept Reprod Health Care. 2008 Mar;13(1):17-24
references.pmid: 17963179
references.citation: Am J Med. 2009 Jun;122(6):497-506
references.pmid: 19486709
references.citation: Am Psychol. 2003 Mar;58(3):224-9
references.pmid: 12772429
references.citation: Perspect Sex Reprod Health. 2006 Jun;38(2):90-6
references.pmid: 16772190
references.citation: Perspect Sex Reprod Health. 2007 Jun;39(2):90-9
references.pmid: 17565622
references.citation: Expert Opin Pharmacother. 2008 Sep;9(13):2317-25
references.pmid: 18710356
references.citation: Obstet Gynecol. 2008 Sep;112(3):670-84
references.pmid: 18757668
references.citation: Fam Plann Perspect. 1998 Mar-Apr;30(2):89-92, 104
references.pmid: 9561874
references.citation: Issues Brief (Alan Guttmacher Inst). 2008;(1):1-8
references.pmid: 18561392
references.citation: Eur J Contracept Reprod Health Care. 2001 Sep;6(3):153-8
references.pmid: 11763979
references.citation: Perspect Sex Reprod Health. 2007 Mar;39(1):48-55
references.pmid: 17355381
references.citation: Fam Plann Perspect. 1995 Nov-Dec;27(6):228-34, 245
references.pmid: 8666086
references.citation: Fam Plann Perspect. 1998 Jan-Feb;30(1):24-9, 46
references.pmid: 9494812
references.citation: Eur J Contracept Reprod Health Care. 2004 Jun;9(2):57-68
references.pmid: 15449817
references.citation: Obstet Gynecol. 2006 Jun;107(6):1453-72
references.pmid: 16738183
references.citation: Contraception. 1999 Jan;59(1 Suppl):17S-20S
references.pmid: 10342091
references.citation: Am J Obstet Gynecol. 2006 May;194(5):1290-5
references.pmid: 16647912
references.citation: Fam Plann Perspect. 1996 Jul-Aug;28(4):154-8
references.pmid: 8853280