Compliance with depot medroxyprogesterone acetate: a randomized, controlled trial of intensive reminders

Abstract

We enrolled women in a prospective, randomized study to determine whether an intensive reminder system would improve compliance in women receiving depot medroxyprogesterone injections. Women selecting this treatment were assigned to a group that received both mail and telephone reminders or to a second group that received only a scheduled appointment at the time of the previous injection. The rate of continuation and the rate of on-time injections did not differ between groups. Women who had prolonged bleeding were more likely to discontinue depot medroxyprogesterone injections.

PIP: Depot-medroxyprogesterone acetate (DMPA) injection is an effective contraceptive that must be given within 14 weeks after previous injection to facilitate effective contraceptive action. This study investigated the effect of an intensive reminder system on the compliance and continuation of DMPA treatment. About 250 women (mean age, 20.7 years) who were not currently on DMPA treatment were enrolled in the study conducted in Pennsylvania between October 1993 and November 1994. These women were given DMPA injections and two groups were formed--those who came back for another treatment and those who came back after a year for 4 additional injections. One group of women received both mail and telephone reminders for treatment compliance, while another group received only a scheduled appointment at the time of the previous injection. Results revealed that the rate of continuation and rate of on-time injections was almost similar between the two groups. Presence of side effects, such as bleeding, would likely cause the discontinuation of the treatment.