RESUMO
Contraceptive compliance is a multifaceted issue that is influenced by many factors. These factors can directly affect the level of patient compliance, thereby affecting contraceptive method efficacy rates. A review of the literature reveals many studies about contraceptive compliance but a dearth of studies addressing how to change noncompliant behaviors. This article describes the contraceptive methods currently available and their efficacy rates. Patient characteristics and the components of compliance are described as they affect contraceptive efficacy and patient care. Suggestions are made for the use of alternative terminology to include adherence to or continuance of a contraceptive method. Health care providers should realize the impact they can have on a patient's education, decision-making process, and ultimate compliance with a contraceptive method. It is the patient, however, who ultimately makes the decision, either actively or passively, to comply or not and whether to have an unplanned pregnancy.
PIP: Compliance with contraception is a multifaceted issue with substantial implications for method efficacy rates. The literature on contraceptive compliance identifies a range of salient factors, including method efficacy, safety, side effects, the client's understanding of use of the method, personal characteristics, noncontraceptive benefits, costs, partner support, and health care provider preferences. This paper reviews compliance-related factors specific to the following contraceptive methods: condoms, diaphragms and cervical caps, spermicides, oral contraceptives, progestin-only pills, injectables, minipills, IUDs, abstinence and fertility awareness, coitus interruptus, voluntary surgical contraception, and postcoital contraception. It then suggests ways health care providers can encourage acceptors to feel more responsible for their contraceptive health. For example, providers can help women to critically evaluate which method is most appropriate for their lifestyle and life stage, evaluate domestic violence as a possible factor in nonadherence, use culturally sensitive materials, provide easily understandable written materials, ensure patients have a follow-up appointment, and reinforce positive behaviors. Ultimately, however, it is the patient who makes the decision, either actively or passively, to comply or not with her contraceptive regimen.
