Start a new OC pack before leaving the doctor's office?

Initiating use of oral contraceptives (OCs) before leaving the physician's office, rather than waiting until the start of the next menses, improves short-term continuation rates and rates of unintended pregnancy, according to the results of a randomized trial.

Young women in particular can experience many obstacles when it comes to contraceptive care. Providing a prescription can present just another delay. So researchers randomly assigned about half of 1,716 women younger than age 25 seeking OCs from one of three publicly funded clinics to ingest the first pill of a new pack in the clinic under direct supervision and the other half to start the pill conventionally.

They found that those women who started the pill before leaving the clinic were 50% more likely (95% CI, 1.0–2.1) to continue to a second OC pack and were slightly less likely to become pregnant within 6 months (HR 0.90; 95% CI, 0.64–1.25); however, the Quick Start method did not improve continuation rates at 3 or 6 months.

Westhoff C, Heartwell S, Edwards S, et al. Initiation of oral contraceptives using a quick start compared with a conventional start: a randomized controlled trial. Obstet Gynecol. 2007;109:1270-1276.