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Medication Adherence and Contraceptive Counseling.

María Inmaculada de Molina-Fernandez1, Laura Reyes-Martí1, Miriam De la Flor-López2

  • 1Nursing Department, Universitat Rovira i Virgili, 43002 Tarragona, Spain.

Healthcare (Basel, Switzerland)
|May 13, 2023
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Summary

The MMAS-4 scale effectively identifies women at high risk of combined oral contraceptive (COC) non-adherence. Poor adherence correlates with missed pills, method issues, and lower satisfaction, highlighting the need for better contraceptive counseling tools.

Keywords:
combined oral contraceptivehormonal contraceptionmidwiferynursing assessmenttreatment adherence and compliance

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Area of Science:

  • Reproductive Health
  • Contraception
  • Patient Adherence

Background:

  • Combined oral contraceptives (COCs) are widely used but their effectiveness is compromised by poor adherence.
  • Objective tools are needed to identify non-adherent users in contraceptive consultations.
  • The MMAS-4 adherence scale's utility in this context is under-explored.

Purpose of the Study:

  • To evaluate the MMAS-4 adherence scale's effectiveness in identifying poor adherence among combined oral contraceptive users.
  • To assess the relationship between adherence levels and contraceptive outcomes.
  • To explore the potential of MMAS-4 for improving contraceptive counseling by midwives.

Main Methods:

  • A multicenter observational study involving 327 women attending contraceptive counseling in Spain.
  • Participants were COC users or intended users.
  • Two interviews were conducted: at consultation and after one year, utilizing the MMAS-4 scale.

Main Results:

  • The MMAS-4 scale identified high-risk behaviors associated with poor adherence.
  • Poorly adherent COC users exhibited a higher risk of missed pills and method-related problems.
  • Lower satisfaction and instances of unplanned pregnancy/emergency contraception were linked to poor adherence.

Conclusions:

  • The MMAS-4 adherence scale is a valuable tool for identifying combined oral contraceptive users at risk of non-adherence.
  • Integrating MMAS-4 into contraceptive consultations can enhance midwife counseling and potentially improve contraceptive outcomes.
  • Objective adherence assessment supports better patient care and reduces unintended pregnancies.