What Does Adherence Mean? Why Should I Care?
- July 7, 2020
- by The Ginger-U Team
The oral contraceptive pill (OCP) is one of the most convenient and popular forms of contraception, especially among young women. However, the need to follow the prescription regimen properly (i.e., adherence) is particularly acute for OCP. Remember that failure to do so can lead to pregnancy!
What Does Adherence Mean?
Adherence means taking medication exactly as it’s prescribed. So, what does medication adherence mean? Well! It refers to zero lapse in following the prescribed regimen. Poor adherence means more frequent than “typical” lapses in following the prescribed medication dosage and routine.
You ask what is typical!? Typical is the average adherence among all women taking the pill. On an average, women on the pill miss one pill per cycle. Those missing two or more pills per cycle have poor adherence.
Let’s say your gynecologist has prescribed one OCP to be taken daily over a 28-day cycle, and you take it at 10 PM before going to bed. Now, perfect adherence will be following this routine every day. It means you should be taking the “right pill” every day at 10 PM for 28 days. If the pill prescription allows deviation from the same time every day, you would still be adherent for a given day as long as you take the pill within the allowed time window. Likewise, if you miss the pill on a given day but take corrective action, you would still be adherent, albeit with missed a day.
So, we mentioned the “right pill”. Here is what it means. The individual pills on an OCP card are not all the same, even though some may look identical. Each has a hormonal composition specific to each day over the period of days a card covers. Therefore, it’s critically important to take the specified pill on a given day, not just any pill on the card. For this reason, birth control pills are packaged in blister cards with a printed calendar to guide the patient.
What’s The Big Deal If Miss A Pill (Or Two)?
Do you know that missing even one pill increases your chance of pregnancy? If yes, you’re among the 10% of women on the pill who understand this. Simply put, your risk of an unplanned pregnancy can increase dramatically with an adherence lapse. Therefore, the importance of medication adherence cannot be overlooked.
OCP is reported to be 99.7% effective when adherence is perfect. In other words, there’s only a 0.3% risk of unplanned pregnancy over the first year with perfect adherence. With typical adherence, however, the risk is 9%. Girl, this is a whopping 30X increase in risk! So, imagine what happens with poor adherence.