Starting oral contraceptives immediately or during next menses did not differ for continued contraceptive use or pregnancy at 6 months

摘要

QUESTIONIn young women, does directly observed, immediate initiation of oral contraceptives (OCs) increase continuation rates and reduce pregnancy compared with standard delayed initiation (during next menses)?METHODSDesign: randomised controlled trial.Allocation: {concealed}.*Blinding: unblinded.Follow-up period: 3 and 6 months.Setting: 3 urban family planning clinics in Atlanta, NewYork, and Dallas, USA.Patients: 1720 women <25 years of age who were sexuallyactive, requesting OCs, and had a current negative pregnancytest. Exclusion criteria were use of OCs within 7 days orDepo-Provera within 6 months, desire for pregnancy withinthe next 6 months, lactational amenorrhoea, or women <18years of age who were postpartum or postabortion.Intervention: 864 women were allocated to the Quick Startgroup. During the initial clinic visit, they opened the OCpackage and were observed taking the first pill. 856 womenwere allocated to the conventional start group and instructedto take the first pill during their next menses. All womenreceived standardised pill-taking instructions, a take-homeinstruction sheet, > =1 package of pills, and directions to usecondoms during the first week of OC use.