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Open Access Research article

Adherence to the oral contraceptive pill: a cross-sectional survey of modifiable behavioural determinants

Gerard J Molloy12*, Heather Graham1 and Hannah McGuinness1

Author Affiliations

1 Division of Psychology, School of Natural Sciences, University of Stirling, Stirling, Scotland, UK

2 School of Psychology, National University of Ireland Galway, Galway, Ireland

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BMC Public Health 2012, 12:838  doi:10.1186/1471-2458-12-838

Published: 2 October 2012

Abstract

Background

Poor adherence to the oral contraceptive pill (OCP) is reported as one of the main causes of unintended pregnancy in women that rely on this form of contraception. This study aims to estimate the associations between a range of well-established modifiable psychological factors and adherence to OCP.

Method

A cross-sectional survey of 130 female University students currently using OCP (Mean age: 20.46 SD: 3.01, range 17–36) was conducted. An OCP specific Medication Adherence Report Scale was used to assess non-adherence. Psychological predictor measures included necessity and concern beliefs about OCP, intentions, perceived behavioural control (pbc), anticipated regret and action and coping planning. Multiple linear regression was used to analyse the data.

Results

Fifty-two per cent of participants reported missing their OCP once or more per month and 14% twice or more per month. In bivariate analysis intentions (r = −0.25), perceived behavioural control (r= −0.66), anticipated regret (r=0.20), concerns about OCP (r =0.31), and action (r= −0.25) and coping (r= −0.28) planning were all significantly associated with adherence to OCP in the predicted direction. In a multivariate model almost half (48%) of the variation in OCP adherence could be explained. The strongest and only statistically significant predictors in this model were perceived behavioural control (β=−0.62, p<0.01) and coping planning (β =−0.23, p=0.03). A significant interaction between intentions and anticipated regret was also observed.

Conclusion

The present data point to a number of key modifiable psychological determinants of OCP use. Future work will establish whether changing these variables results in better adherence to the OCP.

Keywords:
Adherence; Compliance; Oral contraception pill; Intention; Anticipated regret; Beliefs; Planning; Behaviour