High-risk teen compliance with prescription contraception: an analysis of Ohio Medicaid claims

J Pediatr Adolesc Gynecol. 2002 Feb;15(1):15-21. doi: 10.1016/s1083-3188(01)00134-6.


Study objective: This study examines utilization of and compliance with prescription contraception by adolescents.

Design: Retrospective cohort analysis of billing and pharmacy claims.

Setting: Ohio Medicaid fee-for-service enrollees.

Participants: Claims data of 12- to 19-year-olds identified at high risk for pregnancy by sexually related service billing or procedure code.

Main outcome measure: Prescription contraception use and compliance patterns were examined over a 12-month study period.

Results: During a 6-month enrollment period, 3338 females were identified at risk for pregnancy. Over one-fourth (920) became pregnant. Across the 12-month follow-up, 40% (1328) used no prescription contraception and 33% (1090) used some prescribed contraceptive. Most teens used injectable medroxyprogesterone (517) or oral contraceptive pills (492). About 20% of those using any type of prescribed contraceptive were compliant for the full year; less than 30% used a method for 3 months or less. Whites were more compliant with contraception than nonwhites. Younger age and concurrent mental health condition were also predictors of noncompliance.

Conclusions: Teens at risk for pregnancy demonstrated poor compliance with prescribed contraceptives. Billing/pharmacy claims analysis is a useful tool for identifying teens at risk for pregnancy in order to target and evaluate interventions or to benchmark care provided to adolescents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Cohort Studies
  • Contraceptive Agents / supply & distribution*
  • Contraceptive Agents / therapeutic use*
  • Female
  • Humans
  • Insurance Claim Review*
  • Medicaid
  • Ohio
  • Patient Compliance / statistics & numerical data*
  • Pregnancy
  • Pregnancy in Adolescence / prevention & control*
  • Regression Analysis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors


  • Contraceptive Agents