Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
Obstet Gynecol. 2013 Feb;121(2 Pt 1):330-336. doi: 10.1097/AOG.0b013e31827e5898.
To examine factors associated with discontinuation of the oral contraceptive pill (OCP), patch, and ring.
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.
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.
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.
II.
探讨与口服避孕药（OCP）、贴剂和环脱落相关的因素。
我们纳入了避孕选择项目中的 1452 名女性参与者，她们选择了 OCP、贴剂或环，并完成了 12 个月的随访分析。我们将脱落定义为在随访调查中停止避孕方法超过 1 个月。因怀孕或试图怀孕而停止使用方法或失访的参与者被删失。我们在 Cox 比例风险模型中检查了人口统计学、行为和方法相关因素。
贴剂使用者的 1 年脱落率（58%）高于 OCP（47%；P=.03）和环使用者（49%；P=.02）。如果女性是黑人（调整后的危险比[HR]1.21，95%置信区间[CI]1.02-1.44）、不再结婚（调整后的 HR 1.83，95% CI 1.27-2.65）或接受公共援助（调整后的 HR 1.30，95% CI 1.08-1.57），则更有可能停用 OCP、贴剂或环。报告难以获得该方法的女性停药的可能性是其两倍多（调整后的 HR 2.43，95% CI 1.81-3.27）。尽管有副作用，但仍确定会继续使用的女性（调整后的 HR 0.57，95% CI 0.43-0.77）停药的可能性较小。
尽管选择了方法且无需付费获得，但近一半的 OCP 和环使用者以及大多数贴剂使用者在 12 个月内停用了方法。获得方法困难是导致停药率高的原因之一。
II。
