Original Article

Patient Understanding and Use of Oral Contraceptive Pills in a Southern Public Health Family Planning Clinic

Authors: Terry C. Davis, PHD, Doren D. Fredrickson, MD, PHD, Linda Potter, DRPH, Rose Brouillette, MD, Anna C. Bocchini, BA, Mark V. Williams, MD, Ruth M. Parker, MD

Abstract

Objective: To assess patient understanding and use of oral contraceptive pills (OCPs) and determine if these are associated with literacy.


Methods: Four hundred OCP users from a southern public health family planning clinic were orally tested post visit for literacy, demographics, contraceptive knowledge, OCP use, side effects, and adherence.


Results: Patients were predominately African American (86%); 78% had completed high school and 42% read below a 9th grade level. Most (94%) understood what to do when they missed one pill, yet few knew the correct action to take after missing two or three pills (19% and 3% respectively); 33% reported missing one or more pills in the past 2 weeks. Literacy was not associated with OCP use, knowledge, or adherence.


Conclusion: Patients of all literacy levels had limited understanding of OCP side effects and what to do about multiple missed pills. This puts them at risk for misuse.


Key Points


* There is a gap between oral contraceptive pill (OCP) education and patient knowledge in a southern public health family planning clinic.


* After receiving a contraceptive education class and individual OCP counseling, patients had high satisfaction and self-efficacy but relatively limited knowledge of contraception and OCP use, regardless of literacy level.


* Patients’ poor understanding of OCP side effects and what to do about multiple missed pills puts them at risk for misuse.


* Understanding correct usage of OCPs and avoiding unintended pregnancy may involve more complex health literacy skills than providers or patients realize.

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