Columbia University School of Nursing, New York, New York, USA.
J Womens Health (Larchmt). 2010 Dec;19(12):2203-10. doi: 10.1089/jwh.2010.1963. Epub 2010 Oct 30.
Although oral contraception (OC) misuse is presumed to play an important role in unwanted pregnancy, research findings have often been equivocal, perhaps reflecting unaddressed inconsistencies in methodological approaches.
Using established databases, we performed a systematic review of measurement methods for OC use using primary research reports published from January 1965 to December 2009.
Terminology used to describe OC use, which included "continuation," "compliance," and "adherence," differed across studies and was rarely defined. The majority of studies (n = 27 of 38, 71%) relied solely on self-report measures of OC use. Only two reports described survey or interview questions, and reliability and validity data were seldom described. More rigorous measurement methods, such as pill counts (electronic or manual), serum and urinary biomarkers, and pharmacy records, were infrequently employed. Nineteen studies simultaneously used more than one method, but only three studies compared direct and indirect methods.
The lack of a consistent, well-defined measurement of OC use limits our understanding of contraceptive misuse and related negative outcomes. Future research should clarify terminology, develop standardized measures, incorporate multimethod approaches with innovative methods, and publish details of measurement methods.
尽管口服避孕药（OC）的使用不当被认为是导致意外怀孕的一个重要因素，但研究结果往往存在分歧，这或许反映了方法学方法中未解决的不一致性。
我们使用已建立的数据库，对 1965 年 1 月至 2009 年 12 月期间发表的主要研究报告进行了口服避孕药使用测量方法的系统综述。
用于描述 OC 使用的术语（包括“持续”、“依从性”和“坚持性”）在不同的研究中存在差异，且很少有明确定义。大多数研究（38 项研究中有 27 项，71%）仅依赖于 OC 使用的自我报告测量。只有两份报告描述了调查或访谈问题，且很少描述可靠性和有效性数据。更严格的测量方法，如药丸计数（电子或手动）、血清和尿液生物标志物以及药房记录，很少被采用。19 项研究同时使用了多种方法，但只有 3 项研究比较了直接和间接方法。
缺乏对 OC 使用的一致、明确的测量方法限制了我们对避孕不当和相关负面结果的理解。未来的研究应该澄清术语，制定标准化的测量方法，结合创新方法采用多方法方法，并公布测量方法的详细信息。
