title: Compliance with pregnancy prevention measures during isotretinoin therapy.
abstract: BACKGROUND
  Approximately 150 women annually become pregnant while taking isotretinoin despite participation in the iPLEDGE program. Noncompliance with the requirement to be abstinent or use 2 contraceptive methods may be a contributing factor.
  
  
  OBJECTIVE
  We sought to determine the degree of adherence to contraception or abstinence among women taking isotretinoin.
  
  
  METHODS
  We conducted an anonymous survey of women of childbearing potential taking isotretinoin for at least 2 months.
  
  
  RESULTS
  Among 75 participants, 21 (28%) chose abstinence as their primary means of pregnancy prevention, of whom 4 (19%) were sexually active during treatment. The most commonly chosen contraceptive methods among the 39 women who were sexually active were condoms (35, 90%) and oral contraceptive pills (18, 46%). Twelve women (31%) admitted to having intercourse at least once using 1 or fewer forms of contraception; 10 failed to use condoms, and 1 reported completely unprotected intercourse. Among sexually active oral contraceptive pill users, 7 (39%) reported missing 1 or more pills in the previous month.
  
  
  CONCLUSIONS
  Data were self-reported, thus participants may have inaccurately reported contraception use.
  
  
  CONCLUSIONS
  Encouraging the use of highly effective, patient-independent contraception and limiting abstinence to women who have never been sexually active may further reduce the rate of isotretinoin-exposed pregnancies.
authors.affiliation: School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Mary-Katharine
authors.initials: MK
authors.lastname: Collins
authors.affiliation: School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Jacqueline F
authors.initials: JF
authors.lastname: Moreau
authors.affiliation: Medical student, Loyola University of Chicago School of Medicine, Chicago, Illinois.
authors.forename: Dan
authors.initials: D
authors.lastname: Opel
authors.affiliation: Division of Dermatology, Department of Internal Medicine, Loyola University of Chicago School of Medicine, Chicago, Illinois.
authors.forename: James
authors.initials: J
authors.lastname: Swan
authors.affiliation: Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Noel
authors.initials: N
authors.lastname: Prevost
authors.affiliation: Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hastings
authors.affiliation: Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Bimla Schwarz
authors.affiliation: Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: ferrislk@upmc.edu.
authors.forename: Laura
authors.initials: L
authors.lastname: Korb Ferris
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000517:prevention & control; D000152:Acne Vulgaris / Q000188:drug therapy; D000328:Adult; D017280:Condoms; D003267:Contraception; D003268:Contraception Behavior; D003276:Contraceptives, Oral / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000009:adverse effects* / Q000627:therapeutic use; D055118:Medication Adherence; D011247:Pregnancy; D012746:Sexual Abstinence; D014481:United States; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral; D015474:Isotretinoin
keywords: acne; condoms; contraception; iPLEDGE; intrauterine device; isotretinoin; oral contraceptive pills