Providing a logical choice for your patient
R. Nappi
The once-a-month regimen of NuvaRing® contributes to higher
overall satisfaction than traditional oral contraceptives (OCs) because it
requires no daily action from users. In addition, NuvaRing provides excellent
cycle control balanced with a low incidence of estrogen-related side effects,
both of which are key factors in influencing contraceptive acceptability and
compliance.
The user-friendly aspect of the NuvaRing regimen has been
demonstrated in an open-label randomized trial that compared NuvaRing with a 25
µg ethinylestradiol (EE) triphasic combined OC (COC) using the “QuickStart”
protocol-the initiation of a woman’s contraceptive method on the same day of the
physician’s visit regardless of her menstrual cycle day. The likelihood of being
very satisfied with NuvaRing use were three times the likelihood of being very
satisfied with COC use (odds-ratio 3.0; CI 1.5-5.8). Furthermore, when women
were asked to choose a method of contraception for continuation during their
exit interviews, the likelihood of continuation with NuvaRing was eight times
the likelihood of continuation with the COC (odds-ratio 8.4; CI 3.9-18.6).
The high level of satisfaction during NuvaRing use has been well
established in various clinical trials, especially among women with an age range
of 18-40 years. Recently, a randomized study compared acceptability with
NuvaRing and a low dose COC (35 µg EE/0.25 mg norgestimate) in young women aged
15-21 years. The study showed that women preferred NuvaRing to COCs; NuvaRing
was also seen to be easier to use and resulted in fewer concerns about health
risks. Method approval was higher with NuvaRing use compared with COC use as
women liked the rings more and stated that they were more likely to recommend
NuvaRing to friends and use them in the future, compared with COCs.
NuvaRing’s high acceptability and ease of use in the clinical
study setting has been borne out by women’s positive experiences in daily
practice. In the many clinical experience programs that have now been carried
out around the world (in Europe, more than 22,000 women were included in 12
countries), women are unanimous in their satisfaction with the method,
preferring NuvaRing to other methods as the best contraceptive choice available.
Patient acceptability of a method can also be reflected by the
degree of follow-up care required by physicians. In the United States, two
physicians noticed that when they prescribed NuvaRing, women were less likely to
call their offices with questions or complaints. To quantify this finding, a
longitudinal observational study was undertaken involving over 200 women
starting a hormonal contraceptive method of their choice (COCs, the transdermal
patch and the vaginal ring). The number of phone calls per woman was least in
the NuvaRing group, followed by the group using COCs and then the patch group,
respectively. An analysis of the reasons for patient callbacks showed that
NuvaRing users made fewer callbacks for nausea, headache and breast pain
compared with the patch and the group using COCs. This lower rate of callbacks
provides yet another perspective to NuvaRing’s high patient acceptability and
illustrates the fact that NuvaRing allows physicians to provide women with
confidence for the contraceptive success that they seek.