Evaluation of extended and continuous use oral contraceptives

Wright, Katharine M.; Johnson, Jeremiah X.

doi:10.2147/tcrm.s2143

Cited by 34 publications

(6 citation statements)

References 33 publications

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“…However, we conducted the initial usability and usefulness tests of MedBuddy with women who were college students and took oral contraceptives. We selected this population because (1) younger adults are likely to have more technological literacy than middle-aged or older adults and therefore may provide higher quality feedback about the skill with minimal frustration if it does not work as expected, (2) nonadherence to oral contraceptives is common [ 28 , 29 ], and (3) oral contraceptives are most effective when taken at approximately the same time every day [ 30 ]. Following the receipt of an exempt determination by the institutional review board, potential participants were recruited from an urban public university campus in the Southeastern United States.…”

Section: Methodsmentioning

confidence: 99%

Medication Adherence Reminder System for Virtual Home Assistants: Mixed Methods Evaluation Study

Corbett¹,

Combs²,

Chandarana³

et al. 2021

JMIR Form Res

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Background Medication nonadherence is a global public health challenge that results in suboptimal health outcomes and increases health care costs. Forgetting to take medicines is one of the most common reasons for unintentional medication nonadherence. Research findings indicate that voice-activated virtual home assistants, such as Amazon Echo and Google Home devices, may be useful in promoting medication adherence. Objective This study aims to create a medication adherence app (skill), MedBuddy, for Amazon Echo devices and measure the use, usability, and usefulness of this medication-taking reminder skill. Methods A single-group, mixed methods, cohort feasibility study was conducted with women who took oral contraceptives (N=25). Participants were undergraduate students (age: mean 21.8 years, SD 6.2) at an urban university in the Southeast United States. Participants were given an Amazon Echo Dot with MedBuddy—a new medication reminder skill for Echo devices created by our team—attached to their study account, which they used for 60 days. Participants self-reported their baseline and poststudy medication adherence. MedBuddy use was objectively evaluated by tracking participants’ interactions with MedBuddy through Amazon Alexa. The usability and usefulness of MedBuddy were evaluated through a poststudy interview in which participants responded to both quantitative and qualitative questions. Results Participants’ interactions with MedBuddy, as tracked through Amazon Alexa, only occurred on half of the study days (mean 50.97, SD 29.5). At study end, participants reported missing their medication less in the past 1 and 6 months compared with baseline ( χ 2 1 =0.9 and χ 2 1 =0.4, respectively; McNemar test: P <.001 for both). However, there was no significant difference in participants’ reported adherence to consistently taking medication within the same 2-hour time frame every day in the past 1 or 6 months at the end of the study compared with baseline ( χ 2 1 =3.5 and χ 2 1 =0.4, respectively; McNemar test: P =.63 and P =.07, respectively). Overall feedback about usability was positive, and participants provided constructive feedback about the skill’s features that could be improved. Participants’ evaluation of MedBuddy’s usefulness was overwhelmingly positive—most (15/23, 65%) said that they would continue using MedBuddy as a medication reminder if provided with the opportunity and that they would recommend it to others. MedBuddy features that participants enjoyed were an external prompt separate from their phone, the ability to hear the reminder prompt from a separate room, multiple remi...

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Section: Methodsmentioning

confidence: 99%

Medication Adherence Reminder System for Virtual Home Assistants: Mixed Methods Evaluation Study

Corbett¹,

Combs²,

Chandarana³

et al. 2021

JMIR Form Res

View full text Add to dashboard Cite

show abstract

“…Because the non-hormonal pills in a COC pack are placebos, users may opt to discard them and start a new pack early. A key reason COC users do this is to avoid menstruation, which is a component of client self-care and satisfaction with the method ( 36 ). Clear counseling that week 4 of the DPP pack contains oral PrEP pills, which are not placebos and are needed to maintain protection against HIV, will be new to many COC users and critical to ensure correct use of the DPP.…”

Section: Discussionmentioning

confidence: 99%

Equipping providers to offer novel MPTs: Developing counseling messages for the Dual Prevention Pill in clinical studies and beyond

Segal¹,

Harris

Carmone

et al. 2023

Front. Reprod. Health

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IntroductionThe pipeline for multi-purpose prevention technologies includes products that simultaneously prevent HIV, pregnancy and/or other sexually transmitted infections. Among these, the Dual Prevention Pill (DPP) is a daily pill co-formulating oral pre-exposure prophylaxis (PrEP), and combined oral contraception (COC). Clinical cross-over acceptability studies for the DPP require training providers to counsel on a combined product. From February 2021–April 2022, a working group of eight HIV and FP experts with clinical and implementation expertise developed counseling recommendations for the DPP based on existing PrEP/COC guidance.Assessment of policy/guidelines options and implicationsThe working group conducted a mapping of counseling messages from COC and oral PrEP guidance and provider training materials. Six topics were prioritized: uptake, missed pills, side effects, discontinuation and switching, drug interactions and monitoring. Additional evidence and experts were consulted to answer outstanding questions and counseling recommendations for the DPP were developed. Missed pills was the topic with the most complexity, raising questions about whether women could “double up” on missed pills or skip the last week of the pack to recover protection faster. Uptake required aligning the time to reach protective levels for both DPP components and explaining the need to take DPP pills during week 4 of the pack. The potential intensity of DPP side effects, given the combination of oral PrEP with COC, was an important consideration. Discontinuation and switching looked at managing risk of HIV and unintended pregnancy when stopping or switching from the DPP. Guidance on drug interactions contended with differing contraindications for COC and PrEP. Monitoring required balancing clinical requirements with potential user burden.Actionable recommendationsThe working group developed counseling recommendations for the DPP to be tested in clinical acceptability studies. Uptake: Take one pill every day for the DPP until the pack is empty. Days 1–21 contain COC and oral PrEP. Days 22–28 do not contain COC to allow for monthly bleeding, but do contain oral PrEP and pills should be taken to maintain HIV protection. Take the DPP for 7 consecutive days to reach protective levels against pregnancy and HIV. Missed pills: If you miss 1 pill multiple times in a month or 2+ consecutive pills, take the DPP as soon as you remember. Do not take more than 2 pills in a day. If 2+ consecutive pills are missed, only take the last missed pill and discard the other missed pills. Side effects: You may experience side effects when you start using the DPP, including changes to monthly bleeding. Side effects are typically mild and go away without treatment. Discontinuation/switching: If you decide to discontinue use of the DPP, but want to be protected from HIV and/or unintended pregnancy, in most cases, you can begin using PrEP or another contraceptive method right away. Drug interactions: There are no drug-drug interactions from combining oral PrEP and COC in the DPP. Certain medications are not recommended due to their contraindication with oral PrEP or COC. Monitoring: You will need to get an HIV test prior to initiating or restarting the DPP, and every 3 months during DPP use. Your provider may recommend other screening or testing.DiscussionDeveloping recommendations for the DPP as a novel MPT posed unique challenges, with implications for efficacy, cost, and user and provider comprehension and burden. Incorporating counseling recommendations into clinical cross-over acceptability studies allows for real-time feedback from providers and users. Supporting women with information to use the DPP correctly and confidently is critically important for eventual scale and commercialization.

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“…It is imperative that every woman should have knowledge of the adverse effects of hormonal contraceptives. Along with the common side effects like nausea, vomiting, breakthrough vaginal bleeding 11 the diagnosis of decidual casts may be taught to women taking hormonal contraceptives for the first time.…”

Section: Discussionmentioning

confidence: 99%

Decidual casts: Dilemma for clinicians, relief for patients – A case series

Sinha¹,

Siddiqui

Fazal³

et al. 2023

IJOGR

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Decidua is endometrium that is hormonally prepared for pregnancy. Decidual cast is the entire sloughed endometrium that takes the form of the endometrial cavity. It is a rare entity which is the result of high progesterone on uterine endometrium. It has association with intrauterine pregnancy, ectopic pregnancy, incomplete abortion and in non-pregnant states with the use of hormonal pills etc. We are here presenting a case series of decidual casts. We observed that all our patients had a similar history of recent intake of hormonal contraceptives followed by bleeding and passage of fleshy mass from vagina. The differential diagnosis of passage of mass per vaginum includes conditions ranging from benign to malignant, therefore, our study emphasizes the importance of considering it in mind, since it mimics malignancy but is not a signal of a serious condition.

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Evaluation of extended and continuous use oral contraceptives

Cited by 34 publications

References 33 publications

Medication Adherence Reminder System for Virtual Home Assistants: Mixed Methods Evaluation Study

Medication Adherence Reminder System for Virtual Home Assistants: Mixed Methods Evaluation Study

Equipping providers to offer novel MPTs: Developing counseling messages for the Dual Prevention Pill in clinical studies and beyond

Decidual casts: Dilemma for clinicians, relief for patients – A case series

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