New look for Ortho OCs aids patients, providers
Get ready to instruct patients on use of the updated Dialpak oral contraceptive (OC) dispenser from Ortho-McNeil Pharmaceutical in Raritan, NJ. The company just introduced the new packaging with two of its top products, Ortho Tri-Cyclen and Ortho-Cyclen. The company plans to phase in the new packaging in its seven other OC products over the next two years.
Pills are enclosed in a sleek refillable, reusable, and recyclable dispenser case that resembles a makeup compact. When opened, the case displays the pills, which are packaged to fit around a dial ring. Refill packs can be inserted in the case each month, with written instructions to show women how to insert them based on which day they start their pill cycle.
The new Dialpak is ready for instant use with an any-day start and a one-way dial to help minimize the possibility of mistakes. Its clearly numbered pills and days of the week help women keep track during the month, a feature appreciated by Donnica Moore, MD, president of Sapphire Women’s Health Group in Branch burg, NJ.
"From a doctor’s perspective, what I like the most is that each pill is numbered, so if you call me in the middle of your cycle and say, Dr. Moore, I’m having some symptoms,’ I can put that into perspective a whole lot easier by asking what day you are in your cycle," notes Moore. "If you say you are on Day 14 as opposed to saying, I think I got my last period a couple of weeks ago when I was at my aunt’s house,’ it is much more precise this way."
Keeping it simple
While there are no changes in the pills contained in the new Dialpak design, Moore says the packaging will improve the pills’ effectiveness because it makes it easier for women to take them properly. Research shows that compliance problems are common among all age groups, with 47% of women missing one or more pills per cycle, and 22% missing two or more pills per cycle.1
"I haven’t seen the new Dialpak but applaud any effort to help women reliably use OCs" as well as to conserve natural resources), says Michael Rosenberg, MD, MPH, clinical professor of OB/GYN and epidemiology at the University of North Carolina and president of Health Decisions, a private research firm, both in Chapel Hill. "Such effort by manufacturers is an important element of efforts to improve compliance, along with efforts by physicians and patients themselves."
The Dialpak’s discreet design allows it to blend in with other personal items, so women feel more at ease keeping it with them during the day. That feature is an advantage when a pill is missed in the morning, Moore notes. "[The case] is more like a make-up compact so women are more likely to feel comfortable carrying it with them in their purse," she points out. "If they forget to take it first thing in the morning, they can take it second thing in the morning because they will have it with them."
While new packaging can aid in successful pill taking, the provider continues to play a crucial role in encouraging compliance, notes Rosenberg. It is important to let women who are starting OCs know that they may experience side effects such as spotting or bleeding and that the side effects most likely will be transient, he explains.
Education is key
Focus counseling on the transience of most side effects and identify a backup method should there be problems with the pills, he says. Help patients establish a daily pill-taking routine and offer instructions on dealing with a missed pill. Use easy-to-understand literature as "take-home" information.
Finally, patients should be encouraged to contact the provider if they have any questions or do experience difficulties, Rosenberg says. All this needs to presented in a manner that conveys empathy and concern for the patient, as well as enthusiasm for the method.
Whether it is termed "compliance" or "success," remember to focus on the importance of the daily pill regimen, Moore says. The new Dialpak can help women achieve success with pills, she says.
"There are 3 million unwanted pregnancies per year in this country, and 65% of them are from women who say they were using some form of contraception. As far as I am concerned as a gynecologist, any innovation that can reduce that 3 million number is a great step towards making all pregnancies intended pregnancies," she says.
[Want additional information about preparing patients for success with OCs? Read the article on pp. 45-47 in the April 1998 Contraceptive Technology Update. Also, you can see full-color photographs of the new Dialpak design on pp. 90 and 92 in the 1999-2000 edition of A Pocket Guide to Managing Contraception from Bridging the Gap Foundation, Tiger, GA. Ordering information is available by sending a fax request to (706) 265-6009.]
Reference
1. Rosenberg M, Waugh MS. Causes and consequences of oral contraceptive noncompliance. Am J Obstet Gynecol 1999; 180(2 Pt 2):276-279.
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