Effect of tailored versus standard use of the combined oral contraceptive on continuation rates at one year

• Published in: The European journal of contraception & reproductive health care 2012-06, Vol.17, p.S39
• Main Authors: Stephenson, J, Shawe, J, Panicker, S, Akintomide, H, MacGregor, F, Wilkinson, C, Brechin, S, Masters, T, Gunn, C, MacAllister, K, Kubba, A, O'Brien, P A, Webb, A, Brima, N, Chandler, H, Price, T, Sauer, U
• Format: Article
• Language: English
• Subjects: Birth control; Clinical trials; Comparative studies; Drug use; Hemorrhage; Prescription drugs
• ISSN: 1362-5187; 1473-0782

To compare continuation rates in women taking the combined oral contraceptive (COC) at one year following 'tailored' versus standard (21/7) use of the COC. In this trial, tailored use was defined as taking the COC daily until bleeding on three consecutive days triggers a three-day pill-free interval. We hypothesised that tailored use would lead to higher satisfaction with bleeding patterns and hence higher continuation rates. We did a randomised controlled trial (RCT) with eight UK sites in which 503 women aged 18-45 years were randomised (from March 2009 to November 2010) to either standard (n = 252) or tailored (n = 251) use of Microgynon 30... (ethinylestradiol 30 mcg, levonorgestrel 150 mcg). Electronic data capture, including electronic daily bleeding diaries, was used to record women's pill use, including switching to other contraceptive methods, menstrual bleeding patterns and user satisfaction. Preliminary analysis of main outcome data from 311/503 (62%) women (152 [60%] women randomised to standard arm and 151 (63%) to tailored arm) shows that 83% of women in each arm (126/152 standard and 132/159 tailored) were still taking the COC at one year. Overall, 89% of women were satisfied or very satisfied with their method of contraception (93% standard arm, 86% tailored arm) and 83% were satisfied or very satisfied with their bleeding pattern (85% standard arm vs. 80% tailored arm). Although follow-up is still ongoing, preliminary analysis of this RCT shows high continuation rates on the COC at one year, with no difference between women randomised to standard use (21/7) and women randomised to 'tailored' use. Satisfaction rates with method of contraception and bleeding pattern at one year are high in both arms. These preliminary findings suggest that tailored use of Microgynon30... offers a suitable alternative to standard use of the COC but is not associated with better continuation or satisfaction rates at one year. (ProQuest: ... denotes formulae/symbols omitted.)