What’s a simple way to improve adherence to prescription contraceptives? Easy: prescribe a one-year supply. One-year prescriptions also decrease trips to the pharmacy and the health center, thereby promoting social distancing in the time of COVID-19.
Dispensing a year’s worth of contraceptives is even better than prescribing a year’s worth. In the states that allow pharmacist prescribing of contraceptives, longer-interval prescriptions are associated with a higher rate of method continuation. A financial modeling analysis of over 12,000 veterans demonstrates that one-year contraceptive pill dispensing has the potential to lower costs and reduce contraceptive coverage gaps.
What prevents clinicians from prescribing or dispensing a one-year supply? The main barrier is medical tradition. We are trained to use refills as a tool to bring patients back to the office: for follow-up on unrelated issues, to check for side effects or complications, or even for financial reasons. Prescribing a full year’s worth of medication, even for a patient who should come back to the office in a month or two, requires a shift in our thinking. We must separate refills from follow-up.
Try one-year contraceptive prescribing in your office! It’s a simple change that can make life safer and easier for patients.
Judge-Golden CP, Smith KJ, Mor MK, Borrero S. Financial Implications of 12-Month DIspensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System. JAMA Intern Med. 2019;179(9):1201-1208. doi: 10.1001/jamainternmed.2019.1678.
Rodriguez MI, Edelman AB, Skye M, Darney BG. Association of Pharmacist Prescription With Dispensed Duration of Hormonal Contraception. JAMA Netw Open. 2020;3(5):e205-252. doi: 10.1001/jamanetworkopen.2020.5252.
Steenland MW, Rodriguez MI, Marchbanks PA, Curtis KM. How does the number of oral contraceptive pill packs dispensed or prescribed affect continuation and other measures of consistent and correct use? A systematic review. Contraception. 2019;87(5):605-610. doi: 10.1016/j.contraception.2012.08.004.
The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.