Conscientiousness and adherence to oral contraceptives: what are the mechanisms?

Abstract

Background: Approximately half of those using oral contraceptives fail to adhere to the daily regimen, therefore a considerable gap between contraceptive efficacy and effectiveness remains for this method. The personality trait of conscientiousness has been reliably associated with medication adherence, including adherence to the OCP. In this study we present analyses that aim to identify what the primary modifiable social cognitive mediators of this association are. Methods: Two cross-sectional samples (N=150) of current users of oral contraceptives were recruited from a University setting. Conscientiousness and a range of social cognitive predictors were assessed using standardised measures modified for this context. OCP adherence was measured using a modified version of the Medication Adherence Report Scale. Data were collected online. The main study questions were addressed using mediation analyses. Findings: Higher conscientiousness had a medium sized association with better adherence to the OCP. There was evidence for a range of social cognitive mediators of this association including action and coping planning, however there was variability in the replicability of findings in the two samples. Discussion: The modifiable mechanisms that account for the association between conscientiousness and adherence to oral contraceptives may help in the design of interventions to enhance adherence to OCP in those with lower levels of conscientiousness. Low levels of conscientiousness might represent a potential ‘psychological contraindication’ to medications that require significant on-going self-regulatory capacity.