Contraceptive efficacy, compliance and beyond: Factors related to satisfaction with once-weekly transdermal compared with oral contraception

Urdl, Wolfgang; Apter, Dan; Alperstein, Alan; Koll, Peter; Schönian, Siegfried; Bringer, Jacques; Fisher, Alan C.; Preik, Michael; ORTHO EVRA/EVRA 003 Study Group,

doi:10.1016/j.ejogrb.2005.01.021

« Previous Next »European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 121, Issue 2 , Pages 202-210, 1 August 2005

Contraceptive efficacy, compliance and beyond: Factors related to satisfaction with once-weekly transdermal compared with oral contraception

Wolfgang Urdl
- Department for Obstetrics and Gynecology, Unit of Gynecological Endocrinology and Reproductive Medicine, University of Graz, Austria
Dan Apter
- The Sexual Health Clinic, Family Federation of Finland, Helsinki, Finland
Alan Alperstein
- University of Cape Town, Groote Schuur Hospital and Kingsbury Hospital, Cape Town, South Africa
Peter Koll
- Sandton Medi Clinic, Bryanston, South Africa
Siegfried Schönian
- Praxis für Frauenheilkunde, Rheinstetten, Germany
Jacques Bringer
- Hopital Lapeyronie, Montpellier, France
Alan C. Fisher
- Ortho-McNeil Pharmaceuticals, Raritan, USA
Michael Preik
- Medical and Scientific Affairs, Janssen-Cilag GmbH, Neuss, Germany
- Corresponding author. Tel.: +49 2137 955 376; fax: +49 2137 955 642.
ORTHO EVRA/EVRA 003 Study Group
- G. Freude, H. Kittl, A. Staudach, W. Urdl: Austria; J. Amy, M. Degueldre, M. Dhont, A. van Assche: Belgium; U. Ǻgren, D. Apter, E. Granfors, T. Järvi, H. Polvi, P. Sipilä, S. Telimaa, E. Varila: Finland; G. Body, J. Bringer, G. Chaix-Durand, B. Hedon, J.-L. Meyer, C. Quereux, F. Sailly, E. Signon, M. Tournaire: France; K. Greven, R. Klopfer, U. Kohoutek, L. Koos, S. Schönian, R. Schöpp, K. Stahmer, H.-G. Weidenhammer: Germany; A. Borsos, L. Kovacs, Z. Papp, I. Rákóczi: Hungary; S. Friese, F. Helmerhorst, M.V. Kroeks, A. Pennings, L. Pijpers, F. Roumen, J. Schram, H.K. van Weering: Netherlands; A. Malarewicz, S. Radowicki, S. Rozewicki, P. Skalba, M. Szamatowicz, A. Warenik: Poland; A. Alperstein, J. Baker, H. Cronjé, V.A. Hulme, T. Katzeff, P. Koll, J. Moodley, H.C. Odendaal, L. Reynders, G. Tsalacopoulos, Z.M. van der Spuy: South Africa; A. Campana, M. Germond: Switzerland.

Received 30 August 2004; received in revised form 23 December 2004; accepted 28 January 2005.

Abstract

Objective:

To investigate contraceptive efficacy, compliance and user's satisfaction with transdermal versus oral contraception (OC).

Study design: Randomized, open-label, parallel-group trial conducted at 65 centers in Europe and South Africa. One thousand four hundred and eighty-nine women received a contraceptive patch (n=846) or an OC (n=643) for 6 or 13 cycles.

Results:

Overall/method-failure Pearl Indices were 0.88/0.66 with the patch and 0.56/0.28 with the OC (p=n.s.). Compliance was higher at all age groups with the patch compared to the OC. Significantly more users were very satisfied with the contraceptive patch than with the OC. The percentage of patch users being very satisfied increased with age whereas it did not in the OC group. Likewise, improvements of premenstrual symptoms as well as emotional and physical well-being increased with age in the patch-group in contrast to the OC group. Ratings of satisfaction with the study medication correlated weakly with emotional (r=0.33) and physical well-being (r=0.39) as well as premenstrual symptoms (r=0.30; p<0.001).

Conclusion:

Contraceptive efficacy of the patch is comparable to OC, but compliance is consistently better at all age groups. Higher satisfaction with the patch at increasing age may be attributed to improvements in emotional and physical well-being as well as reduction of premenstrual symptoms.

Keywords: Transdermal contraceptive patch, Oral contraceptive, Efficacy, Safety, Compliance, Satisfaction