Reminder Card helps patients remember OCs
Wash your face, brush your teeth, and take your birth control pill — just part of the daily routine for women who use oral contraceptives (OCs). However, one in five women currently has difficulty maintaining a daily pill schedule.1 Missed pills can equal unintended pregnancy: Women who miss one or more pills per cycle are almost three times as likely to experience an unintended pregnancy while using pills than women who are consistent pill takers.2
Organon of West Orange, NJ, has developed the Reminder Card to help women remember to take their pills on a regular basis. The plastic card, about the size and shape of a credit card, contains a microchip timer. The directions on the Reminder Card read as follows:
When taking your first pill:
• Press the start/stop button for three seconds.
• Card beeps and is activated.
• When your next pill is due, the card will remind you with beeping sounds.
• Take the next pill and stop the sound by pressing the start/stop button.
(To see and hear the Reminder Card, visit the Web at www.organonwomenshealth.com.)
"The Reminder Card, very simply, is an extension of our commitment to contraception," says Organon spokesperson Reid Lubin. "Compliance is an important issue with women, and with us."
The Reminder Card is being made available free to providers who use the Starter Kits issued by the company for new-start patients on the Mircette OC. (See Contraceptive Technology Update, July 1998, p. 85, for more information on Mircette, a 20 mcg pill with a shortened pill-free interval.) The Starter Kit consists of a green zippered pouch with a toothbrush, bar of soap, and a pack of birth control pills. Family planning clinics that receive the Starter Kits in their bulk orders of Mircette will get the Reminder Cards, says Lubin.
"It helps to create a habit, something to jog their memory," says Lubin of the addition of the Reminder Card. "It just adds one more tool to achieving compliance."
Organon is to be applauded for the first major step toward recognizing compliance as an issue, 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.
"Whether this compliance aid will prove useful is presently unknown, but this reminder is an important first step in the right direction," says Rosenberg, who has conducted research on the subject. "The challenge with compliance in the past has always been predictability in a woman’s life."
About 50% of women take birth control pills as prescribed; 25% miss one pill per month (defined as taking more than 24 hours late or not at all); and 25% miss two or more pills per month, according to Rosenberg.
Women who have problems taking pills will tend to experience more side effects such as bleeding, spotting, and discontinuation, he notes, adding that those problems also are leading reasons for unscheduled calls and visits to providers.
If women do discontinue OCs, they often fail to adopt a new method of contraception, or they use a less reliable method, such as condoms.3 These patients are a concern for providers, says Hester Sonder, MD, FACOG, a clinical instructor with the Temple University’s school of medicine and owner of a private GYN practice, both in Philadelphia.
"They will discontinue their pills because they know that they can’t remember to take them," says Sonder. "They have had problems with breakthrough bleeding, having to double up on pills, and having so many problems that they just stop their pills when they come back to see me in three months."
Another tool in the kit
The Reminder Card is a further step in the right direction in helping women become successful pill takers, Sonder says. Many of her patients have found the Starter Kit a useful tool in keeping on track, so the Reminder Card is an added bonus.
"My patients love the Starter Kit and usually will bring it back and pop it out in my consultation room just to show me they are using it," she notes. "Now, I’m going to be able to start my patients off with a verbal explanation of my own, open up that little green zippered pouch, take out the pack of pills, then the Reminder Card, and explain how to set it."
Sonder usually schedules a three-month follow-up visit for new-start OC users. Those who began using Mircette prior to the introduction of the Reminder Card will get one on the follow-up visit.
"If I haven’t given it to them in the beginning, I would certainly give them a Reminder Card at that time, because this tool really is revolutionary," says Sonder. "It is brilliant, yet incredibly simple."
References
1. EDK Associates, for the Association of Reproduc - tive Health Professionals. The Paradox of the Pill: Oral Contraceptives and Today’s Woman. New York City; Febru - ary 1997.
2. Rosenberg MJ, Waugh MS, Meehan TE. Use and misuse of oral contraceptives: Risk indicators for poor pill taking and discontinuation. Contraception 1995; 51:283-288.
3. Rosenberg MJ, Waugh MS, Long S. Unintended pregnancies and use, misuse, and discontinuation of oral contraceptives. J Repro Med 1995; 40:355-360.
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