Compliance with contraceptives and other treatments

OBJECTIVE: To define some of the issues unique to compliance with oral contraceptives, and some comparisons with other preventive and therapeutic treatments. DATA SOURCES: Reports of compliance with medical treatment were used, with a focus on studies using microelectronic monitoring to assess compliance. Studies included the general population and a variety of demographically different groups. METHODS OF STUDY SELECTION: Twenty-nine studies of medication compliance (including surveys and clinical trials with specific interventions), across a broad range of medical disorders, were selected for comparison with reports of oral contraceptive compliance. TABULATION, INTEGRATION, AND RESULTS: Rates of compliance with contraceptive methods are low, but differ little from rates of compliance with other medical treatments. Several questions might be used to ascertain the likelihood that an individual is willing to use an oral contraceptive as prescribed (eg, willingness to take a daily pill, to return for follow-up, and to report adverse effects). CONCLUSIONS: Studies of a variety of medical disorders have shown that no consequence is so severe that all patients can be assumed to comply with the prescribed treatment plan. Inadequate compliance often diminishes treatment efficacy, which suggests the need for alternative methods that do not require daily compliance.