Table 3

Outcomes of studies included in the effectiveness review

CitationResults
2006–2008 The Border Contraceptive Access Study10 12 13Continuation of OCs
Discontinuation of OCs over 9 months: OTC: 20.8% (97/466), clinic: 25.1% (119/474), p=0.12
Unadjusted Cox proportional hazards model, clinic versus OTC: unadjusted HR: 1.48 (95% CI 1.07 to 2.04), adjusted HR: 1.58 (95% CI 1.11 to 2.26)
Life table estimates of continuation at 9 months were 5% higher for OTC users than clinic users (p<0.01).
Health impacts: use of OCs despite contraindications
Unadjusted regression model for at least one category 3 or 4 contraindication, OTC versus clinic: unadjusted OR: 1.69 (95% CI 1.22 to 2.36), adjusted OR: 1.59 (95% CI 1.11 to 2.29), p=0.012
Hypertension
 Any hypertension (140/90 mm Hg or more)
 Hypertension 140–159/90–99 mm Hg
 Hypertension 160/100 mm Hg or more
 Smoking and age 35 years or older
 Smokes less than 15 cigarettes per day
 Smokes 15 or more cigarettes per day
 Migraine headaches with aura
 Current gall bladder disease
 High cholesterol and using medication
 Diabetes with complications
 Current liver disease or history of liver cancer
 History of or current heart disease
 Previous heart attack or stroke
 History of thrombosis or pulmonary embolism
 Current use of medications for tuberculosis or seizure
 History of or current breast cancer
 Classification of assessed contraindications
 Any category 3 contraindication
 Any category 4 contraindication
 Any category 3 or 4 contraindication
Clinic users
n (%)
29 (5.6)
23 (4.5)
6 (1.2)
16 (3.1)
0 (0.0)
21 (4.1)
5 (1.0)
2 (0.4)
2 (0.4)
0 (0.0)
1 (0.2)
0 (0.0)
1 (0.2)
1 (0.2)
0 (0.0)
44 (8.6)
27 (5.3)
71 (13.8)
OTC users
n (%)
49 (9.8)
42 (8.4)
7 (1.4)
32 (6.4)
2 (0.4)
21 (4.2)
8 (1.6)
3 (0.6)
1 (0.2)
3 (0.6)
1 (0.2)
2 (0.4)
1 (0.2)
1 (0.2)
1 (0.2)
70 (13.4)
37 (7.4)
107 (21.4)
P value
0.013
0.036
0.017
0.932
0.377
0.633
0.578
0.079
0.986
0.152
0.986
0.986
0.311
0.006
0.162
0.002
Health impacts: side effects
 Reported side effects: OTC: 22.3% (104/466), clinic: 30.4% (144/474), p<0.01
Client satisfaction
 3/4 of clinic users and >70% of pharmacy users said they were very satisfied with their source. Only about 4% of each group said they were either somewhat or very unsatisfied with their source.
2000 Mexican National Health Survey analysis14Health impacts: use of OCs despite contraindications
Clinic users(%)OTC users(%)All p values non-significant
Hypertension (≥160/100 mm Hg)1.81.7
 Age <351.11.2
 Age ≥354.23.1
Smoking and age ≥357.59.4
Any contraindication3.64.5
 Age ≥351.11.2
 Age ≥3511.612.8
1979 Mexico National Fertility and Mortality Study9Continuation of OCs
First method continuation rates per 100 women who accepted OCs as their first method, by initial source of supply (1974–1979)
Private physician/clinic usersGovernment programme usersOTC users
Total at 12 months595760
 Age <25575655
 Age 25+615866
1974 Colombian Fertility and Contraceptive Use Survey11Continuation of OCs
First method continuation of OCs over 12 months: OTC: 79.2 per 100 women (unweighted number of users completing period n=191), clinic: 84.2 per 100 women (n=400)
First method continuation of OCs over 24 months: OTC: 68.8 per 100 women (n=131), clinic: 74.3 per 100 women (n=269)
Note: A January 1975 validation survey indicated that first-segment OC continuation rates were overestimated by approximately 10%–15%.
Life table estimates of OC continuation at 12 and 24 months were approximately 5% higher for clinic users than OTC users.
Health impacts: side effects
Clinic users(%)n=587OTC users (%) n=295
Reported any side effects while using OCs44.451
Reported thrombophlebitis00
Reported thromboembolism00
Reported weight changes7.24.9
Reported varices4.53.4
Reported headache27.425.1
Reported nervousness10.715.3
Reported skin problems6.214.7
Reported pain2.810.1
Reported bleeding problems3.75.2
Reported various other side effects (not specified)37.521.2
  • OC, oral contraceptive;OTC, over the counter.