According to DH statistics, in 2011, 189,931 terminations of pregnancy were performed in England and Wales. Some were caused by contraceptive failure or by changed circumstances in the context of a planned pregnancy. However, for some women, the termination was due to non-engagement with contraception, which can be for many different reasons.
The impact of such a non-engagement is both financial (for health services) but often emotional for the woman herself. Staff in contraceptive services work hard to encourage consistent contraceptive use, but may experience a range of barriers.
NICE defines adherence as 'the extent to which the patient's action matches the agreed recommendations'.1 It recommends clinicians assist patients to make informed decisions about treatment and use medicines to best effect.
NICE, in its paper on medicine adherence, mainly addresses health professionals who prescribe medications to help patients who are unwell. In contraceptive services, the client group is predominantly healthy women of childbearing age. They may have strong opinions about different methods and be influenced by family, friends and the media.