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Contraceptive Pearl: Contraceptive Adherence and Patients’ Choice

Contraceptive counseling is more art than science. Success depends heavily on timing, interpersonal skills, and other intangible, hard-to-measure factors – and despite its obvious importance, contraceptive counseling is an area in which there’s very little evidence to guide us. In fact, efforts to improve adherence to chronic medication regimens in other areas of medicine (among patients with epilepsy, hypertension, and diabetes) have yielded lackluster results.

Nevertheless, here’s one quick tip to improve contraceptive adherence: Whenever possible, honor your patient’s choice.

A retrospective study of 1,945 women at a family planning clinic in Indonesia found that among women who had a clear preference for a particular method at the start of their visit, adherence at one year was much higher if they were granted their choice – no matter what that choice was.

So if your patient asks for a particular brand of birth control pill, prescribe that one unless there’s a super-clear reason to choose another.

We appreciate your feedback! Please write us at with any questions, comments or additional resources to add to our list.



Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence.Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD000011. DOI:10.1002/14651858.CD000011.pub3.

Pariani S, Heer DM, Van Arsdol MD Jr. Does choice make a difference in contraceptive use? Evidence from East Java. Stud Fam Plann. 1991 Nov-Dec; 22(6): 384-90.



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.