Evidence map›Paper›PMID 29847539›Full record

ArticleMedical care2018

The Relationship Between Prescription Copayments and Contraceptive Adherence in a New-user Cohort.

Cassondra Marshall, Julie Schmittdiel, Malini Chandra, Amanda Calhoun, Tina Raine-Bennett

Abstract read
In one paragraph

Article in Medical care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Cassondra MarshallDivision of Research, Kaiser Permanente Northern California.
Julie SchmittdielDivision of Research, Kaiser Permanente Northern California.
Malini ChandraDivision of Research, Kaiser Permanente Northern California.
Amanda CalhounDepartment of Obstetrics and Gynecology, Kaiser Permanente Northern California, Oakland Medical Center, Oakland, CA.
Tina Raine-BennettDivision of Research, Kaiser Permanente Northern California.

Funding

NIMHD NIH HHS L60 MD012113
6 · The paper itself

Abstract

backgroundContraceptive nonadherence is an important contributor to unintended pregnancy in the United States. While the elimination of patient cost sharing has been cited as means to improve contraceptive access, little is known about the relationship between cost sharing and ongoing adherence and continuation of chosen methods. The purpose of this study was to examine the relationship between copayment amount and adherence to pharmacy-dispensed contraception in young women.

methodsWe conducted a retrospective cohort study of 39,142 women ages 19-29 with a new prescription for the contraceptive pill, patch, or ring at Kaiser Permanente Northern California during 2011-2014. We examined 12-month nonadherence as measured by timely prescription refills and used multivariable Cox proportional hazards models to assess the association between copayment amount and the risk of nonadherence.

resultsNinety-four percent of women used the pill, and 6% used the patch or ring. Forty percent of patients had no copayment and 25% had a copayment of ≥$30. Nearly 75% of women were nonadherent during the study period. In 2013 and 2014, women with a copayment had a 9% increased risk of nonadherence (adjusted hazard ratio, 1.09; 95% confidence interval, 1.04, 1.14) compared with women with no copayment.

conclusionsPrescription copayments may serve as a barrier to adherence of pharmacy-dispensed contraception. Given recent changes to Affordable Care Act contraceptive coverage requirement, these findings can be used to support state-level and health system-level policies for no-cost contraception, and to determine the potential public health impact of this policy change.

Indexed as

Drug MonitoringWomen's HealthAdultCaliforniaContraceptionContraceptive AgentsCost SharingFemaleHumansLongitudinal StudiesModels, StatisticalPatient Protection and Affordable Care ActPregnancyRetrospective StudiesContraceptive Agents

Identifiers

PMID29847539
PMCPMC6520255

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.