title: Continuation of prescribed compared with over-the-counter oral contraceptives.
abstract: OBJECTIVE
  To estimate differences in continuation of oral contraceptive pills (OCPs) between U.S. resident women obtaining pills in U.S. family planning clinics compared with over-the-counter in Mexican pharmacies.
  
  
  METHODS
  In El Paso, Texas, we recruited 514 OCP users who obtained pills over the counter from a Mexican pharmacy and 532 who obtained OCPs by prescription from a family planning clinic in El Paso. A baseline interview was followed by three consecutive surveys over 9 months. We asked about date of last supply, number of pill packs obtained, how long they planned to continue use, and experience of side effects. Retention was 90%, with only 105 women lost to follow-up.
  
  
  RESULTS
  In a multivariable Cox proportional hazards model, discontinuation was higher for women who obtained pills in El Paso clinics compared with those who obtained their pills without a prescription in Mexico (hazard ratio 1.6, 95% confidence interval [CI] 1.1-2.3). Considering the number of pill packs dispensed to clinic users, discontinuation rates were higher (hazard ratio 1.8, 95% CI 1.2-2.7) for clinic users who received one to five pill packs. However, there was no difference in discontinuation between clinic users receiving six or more pill packs and users obtaining pills without a prescription.
  
  
  CONCLUSIONS
  Results suggest providing OCP users with more pill packs and removing the prescription requirement would lead to increased continuation.
authors.affiliation: From the Population Research Center, University of Texas at Austin, Austin, Texas; the Department of Languages and Linguistics, University of Texas at El Paso, El Paso, Texas; the College of Nursing, New York University, New York, New York; and Ibis Reproductive Health, Oakland, California.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Potter
authors.forename: Sarah
authors.initials: S
authors.lastname: McKinnon
authors.forename: Kristine
authors.initials: K
authors.lastname: Hopkins
authors.forename: Jon
authors.initials: J
authors.lastname: Amastae
authors.forename: Michele G
authors.initials: MG
authors.lastname: Shedlin
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Powers
authors.forename: Daniel
authors.initials: D
authors.lastname: Grossman
mesh_terms: D000293:Adolescent; D000328:Adult; D003276:Contraceptives, Oral; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008800:Mexico; D004366:Nonprescription Drugs; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D013781:Texas; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral; D004366:Nonprescription Drugs