Women's Health Watch
NOVEMBER 22, 2010
Women’s Health Watch
Texting Fails to Improve Adherence to Birth Control
Women need more than a daily text message from their health care provider to remember to take their oral contraceptive pills, according to a new study. The research, conducted at a Planned Parenthood Clinic in Boston, Massachusetts, casts some doubt on the promise of text messages as a tool to improve medication adherence.
Lead researcher Melody Y. Hou, MD, MPH, of Boston University, recruited 82 women who were sexually active, had a mobile phone with text-messaging capabilities, and wanted to continue taking oral contraceptives for at least 6 months. Dr. Hou and her colleagues assigned the participants their choice of a commercially available oral contraceptive and an electronic monitoring device, which remotely tracked adherence by reporting missed doses.
The reminders had little or no effect on adherence, which was typically poor. On average, women in the intervention group missed as many pills per cycle—approximately 5—as those in the nonintervention group. Only 16% of the women studied had excellent adherence, defined as missing no more than 1 dose per cycle. The results were published in the September issue of Obstetrics and Gynecology.
Despite the study’s inconclusive outcome, health care providers should not rule out text message reminders as a useful component of a more comprehensive, patient-centered adherence program. In the study, most women reported high levels of satisfaction with the text message reminders—with 86% saying they would consider continuing the system and 57% saying they would be willing to pay a monthly fee for the service.
Brisk Walking May Lower Breast Cancer Risk
A brisk daily walk might be just enough exercise to protect women from breast cancer after menopause, new research suggests. In a study involving nearly 100,000 postmenopausual women, researchers found that those who walked briskly for 1 hour every day were 15% less likely to develop breast cancer than those who walked less than 1 hour per week.
The results of the study, published in the October issue of Archives of Internal Medicine, also provide an incentive for women who are less active at the start of menopause to begin a moderate exercise regimen. Even previously sedentary women who increased their activity after menopause lowered their risk by 10%, according to the research.
Led by A. Heather Eliassen, ScD, a team of researchers from Brigham and Women’s Hospital, Harvard Medical School, and the Harvard School of Public Health analyzed data collected from 95,396 women over a period of 20 years. In addition to brisk walking, which had the greatest protective effect, the researchers examined the benefits of other types of exercise, including swimming, hiking, and jogging.
These vigorous exercises, though beneficial, may not be necessary to ward off breast cancer, according to Dr. Eliassen. She recommends that women of all ages consider a moderate routine that includes walking at a brisk pace of 3 to 4 miles per hour for approximately 60 minutes each day.
8 HPV Types Cause Most Cervical Cancer Cases
A landmark study recently found that 90% of all cervical cancer worldwide is caused by 8 human papillomavirus (HPV) types, which scientists say should become priority targets for future vaccines. The results were published October 15, 2010, online in The Lancet Oncology.
In the international retrospective study, researchers examined tissue samples collected from 10,575 cases of cervical cancer spanning 60 years and originating in 38 different countries. The team, led by Silvia de Sanjose, MD, of the Catalan Institute of Oncology in Barcelona, used DNA testing and a technique called polymerase chain reaction to identify the HPV genotypes present in the samples. The results showed that 8 types—16, 18, 45, 33, 31, 52, 58, and 35— were the cause of more than 90% of all cases.
There are currently 2 HPV vaccines available, including Gardasil, produced by Merck, and Cervarix, produced by GlaxoSmithKline. These protect against HPV types 16 and 18—which cause 70% of all cervical cancer—and partially against types 31 and 45. The results of the study, called “the largest assessment of HPV genotypes to date,” are expected to guide the development of more effective HPV vaccines in the future. PT
Fast Fact: One of 4 women will die within 1 year of an initial stroke.