Factors associated with 12-month discontinuation among contraceptive pill, patch, and ring users.
OBJECTIVE
To examine factors associated with discontinuation of the oral contraceptive pill (OCP), patch, and ring.


METHODS
We included 1,452 female participants from the Contraceptive CHOICE Project who selected the OCP, patch, or ring and completed 12 months of follow-up for this analysis. We defined discontinuation as stopping the contraceptive method for longer than 1 month during a follow-up survey. Participants who stopped their method as a result of pregnancy or to attempt pregnancy or who were lost to follow-up were censored. We examined demographic, behavioral, and method-related factors in the Cox proportional hazard models.


RESULTS
Patch users had a higher 1-year discontinuation rate (58%) than OCP (47%; P=.03) and ring users (49%; P=.02). Women were more likely to discontinue the OCP, patch, or ring if they were black (adjusted hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.02-1.44), no longer married (adjusted HR 1.83, 95% CI 1.27-2.65), or received public assistance (adjusted HR 1.30, 95% CI 1.08-1.57). Women who reported difficulty obtaining the method were more than twice as likely to discontinue (adjusted HR 2.43, 95% CI 1.81-3.27). Women who were certain they would continue despite side effects (adjusted HR 0.57, 95% CI 0.43-0.77) were less likely to discontinue.


CONCLUSIONS
Despite selecting their method and obtaining it at no cost, almost half of OCP and ring users and a majority of patch users discontinued their method by 12 months. Experiencing difficulty obtaining the method contributes to high rates of discontinuation.


METHODS
II.
Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
Jourdan E
JE
Stuart
Gina M
GM
Secura
Qiuhong
Q
Zhao
Meredith E
ME
Pittman
Jeffrey F
JF
Peipert
D003274:Contraceptive Devices, Female; D003276:Contraceptives, Oral; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011446:Prospective Studies; D013997:Time Factors; D057968:Transdermal Patch; D055815:Young Adult; D016903:Drug Monitoring
D003276:Contraceptives, Oral