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Riboflavin, Self-report, and Serum Norethindrone: Comparison of Their Use as Indicators of Adolescent Compliance With Oral Contraceptives

Riboflavin, Self-report, and Serum Norethindrone: Comparison of Their Use as Indicators of... Abstract • The purpose of this study was to test the reliability of using the tablet marker, riboflavin, as an indicator of adolescent compliance with oral contraceptives, as compared with self-reports and more costly quantitative determinations of serum norethindrone levels. In a pilot study, a total of 31 urine samples were obtained from 11 subjects, aged 14 to 18 years. A follow-up study was conducted on 26 girls, aged 14 to 19 years, who were randomly selected from an ongoing study of oral contraceptive compliance. Subjects were given an oral contraceptive (Ortho-Novum 1/35), combined with 28 mg of riboflavin. In both studies, urinary fluorescence tests for riboflavin and self-reports were found to be significantly associated. In the follow-up study, both self-reports and urinary fluorescence tests were significantly associated with serum norethindrone levels. When the urinary fluorescence test agreed with self-report, compliance or noncompliance was confirmed by serum norethindrone levels in 90% of the cases. The findings suggest that riboflavin, combined with self-report, can be used as an accurate and cost-effective indicator of adolescent compliance with oral contraceptives. (AJDC 1984;138:70-73) References 1. Zelnik M, Kanter JF: Sexual activity, contraceptive use, and pregnancy among metropolitan-area teenagers: 1971-1979 . Fam Plann Perspect 1980;12:230-237.Crossref 2. Litt IF, Cuskey WR, Rudd S: Identifying adolescents at risk for non-compliance with contraceptive therapy . J Pediatr 1980;96:742-745.Crossref 3. Gordis L: Conceptual and methodologic problems in measuring patient compliance , in Haynes RB, Taylor DW, Sackett DL (eds): Compliance in Health Care . Baltimore, The Johns Hopkins University Press, 1979, pp 23-48. 4. Litt IF, Cuskey WR: Compliance with medical regimens during adolescence . Pediatr Clin North Am 1980;27:3-15. 5. Haynes RB: Strategies for enhancing patient compliance . Drug Therapy, January 1982, pp 33-40. 6. Porter AMW: Drug defaulting in general practice . Br Med J 1969;1:218-222.Crossref 7. Deuschle K, Jordahl C, Hobby G: Clinical usefulness of riboflavin-tagged isoniazid for selfmedication in tuberculosis patients . Am Rev Respir Dis 1960;82:1-10. 8. Hobby GL, Deuschle KW: The use of riboflavin as an indicator of isoniazid ingestion in selfmedicated patients . Am Rev Respir Dis 1959;80: 415-423. 9. Roth HP, Caron HS, Hsi BP: Measuring intake of a prescribed medication: A bottle count and a tracer technique compared . Clin Pharmacol Ther 1970;11:228-237. 10. Ryan WL, Carver MJ, Haller J: Phenolsulfonphthalein as an index of drug ingestion . Am J Pharmacol 1962;134:168-176. 11. Silberstein R, Blackman S: A method to evaluate whether patients take prescribed medication . Clin Pediatr 1966;5:239-240.Crossref 12. Joyce CR: Patient and the sensitivity of clinical trials . J Chronic Dis 1962;15:1025-1036.Crossref 13. Jones IH: Riboflavin as an indicator of drug taking behavior . Med J Aust 1967;1:202-204. 14. Jay S, Litt IF: Riboflavin as an indicator of oral contraceptive compliance . J Adolesc Health Care 1980;1:178.Crossref 15. Parker CR, Ellegood JO, Mahesh VB: Methods for multiple steroid radioimmunoassay . J Steroid Biochem 1975;6:1-8.Crossref 16. Mills TM, Lin TJ, Braselton WE, et al: Metabolism of oral contraceptive drugs: The formulation and disappearance of metabolites of norethindrone and mestranol after intravenous and oral administration . Am J Obstet Gynecol 1976;126:987-996. 17. Mahesh VB, Mills TM, Lin TJ, et al: Metabolism, metabolic clearance rate of blood metabolites, and blood half-life of norethindrone and mestranol , in Garratini S, Berendes HW (eds): Pharmacology of Steroid Contraceptive Drugs . New York, Raven Press, 1977, pp 117-130. 18. Nie NH, Hull CH, Jenkins JT, et al: Statistical Package for the Social Sciences , ed 2. New York, McGraw-Hill Book Co, 1975. 19. Haynes RB, Taylor DW, Snow JC, et al: Annotated and indexed bibliography on compliance with therapeutic and preventive regimens , in Haynes RB, Taylor DW, Sackett DL (eds): Compliance in Health Care . Baltimore, The Johns Hopkins University Press, 1979, pp 337-474. 20. Camfield C, Chaplin S, Doyle AB, et al: Side effects of phenobarbital in toddlers: Behavioral and cognitive aspects . J Pediatr 1979;95: 361-365.Crossref 21. Sanpitak N, Chayutimonkul L: Oral contraceptives and riboflavin nutrition . Lancet 1974;1:836-837.Crossref 22. Newman LJ, Lopez R, Choe HS: Riboflavin deficiency in women taking oral contraceptive agents . Am J Clin Nutr 1978;31:247-249. 23. Gershwin MI, Steinberg AD: Oral contraceptives and vitamin nutrients . Lancet 1974;1: 1234-1235. 24. Wynn V: Vitamins and oral contraceptive use . Lancet 1975;1:561-564.Crossref 25. Jusko WJ, Levy G: Absorption, protein binding, and elimination of riboflavin , in Rivlin RS (ed): Riboflavin . New York, Plenum Press, 1975, pp 99-152. 26. Jusko WJ, Levy G: Absorption, metabolism, and excretion of riboflavin 51-phosphate in man . J Pharm Sci 1967;56:58-61.Crossref 27. Jusko WJ, Khanna N, Levy G, et al: Riboflavin absorption and excretion in the neonate . Pediatrics 1970;45:945-949. 28. Jay S, DuRant RH, Shoffitt T, et al: The effect of peer counselors on adolescent compliance with oral contraceptives. Pediatrics, in press. 29. DuRant RH, Jay S, Linder CW, et al: The influence of psychosocial factors on adolescent compliance with oral contraceptives. J Adolesc Health Care, in press. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Riboflavin, Self-report, and Serum Norethindrone: Comparison of Their Use as Indicators of Adolescent Compliance With Oral Contraceptives

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1984.02140390058018
Publisher site
See Article on Publisher Site

Abstract

Abstract • The purpose of this study was to test the reliability of using the tablet marker, riboflavin, as an indicator of adolescent compliance with oral contraceptives, as compared with self-reports and more costly quantitative determinations of serum norethindrone levels. In a pilot study, a total of 31 urine samples were obtained from 11 subjects, aged 14 to 18 years. A follow-up study was conducted on 26 girls, aged 14 to 19 years, who were randomly selected from an ongoing study of oral contraceptive compliance. Subjects were given an oral contraceptive (Ortho-Novum 1/35), combined with 28 mg of riboflavin. In both studies, urinary fluorescence tests for riboflavin and self-reports were found to be significantly associated. In the follow-up study, both self-reports and urinary fluorescence tests were significantly associated with serum norethindrone levels. When the urinary fluorescence test agreed with self-report, compliance or noncompliance was confirmed by serum norethindrone levels in 90% of the cases. The findings suggest that riboflavin, combined with self-report, can be used as an accurate and cost-effective indicator of adolescent compliance with oral contraceptives. (AJDC 1984;138:70-73) References 1. Zelnik M, Kanter JF: Sexual activity, contraceptive use, and pregnancy among metropolitan-area teenagers: 1971-1979 . Fam Plann Perspect 1980;12:230-237.Crossref 2. Litt IF, Cuskey WR, Rudd S: Identifying adolescents at risk for non-compliance with contraceptive therapy . J Pediatr 1980;96:742-745.Crossref 3. Gordis L: Conceptual and methodologic problems in measuring patient compliance , in Haynes RB, Taylor DW, Sackett DL (eds): Compliance in Health Care . Baltimore, The Johns Hopkins University Press, 1979, pp 23-48. 4. Litt IF, Cuskey WR: Compliance with medical regimens during adolescence . Pediatr Clin North Am 1980;27:3-15. 5. Haynes RB: Strategies for enhancing patient compliance . Drug Therapy, January 1982, pp 33-40. 6. Porter AMW: Drug defaulting in general practice . Br Med J 1969;1:218-222.Crossref 7. Deuschle K, Jordahl C, Hobby G: Clinical usefulness of riboflavin-tagged isoniazid for selfmedication in tuberculosis patients . Am Rev Respir Dis 1960;82:1-10. 8. Hobby GL, Deuschle KW: The use of riboflavin as an indicator of isoniazid ingestion in selfmedicated patients . Am Rev Respir Dis 1959;80: 415-423. 9. Roth HP, Caron HS, Hsi BP: Measuring intake of a prescribed medication: A bottle count and a tracer technique compared . Clin Pharmacol Ther 1970;11:228-237. 10. Ryan WL, Carver MJ, Haller J: Phenolsulfonphthalein as an index of drug ingestion . Am J Pharmacol 1962;134:168-176. 11. Silberstein R, Blackman S: A method to evaluate whether patients take prescribed medication . Clin Pediatr 1966;5:239-240.Crossref 12. Joyce CR: Patient and the sensitivity of clinical trials . J Chronic Dis 1962;15:1025-1036.Crossref 13. Jones IH: Riboflavin as an indicator of drug taking behavior . Med J Aust 1967;1:202-204. 14. Jay S, Litt IF: Riboflavin as an indicator of oral contraceptive compliance . J Adolesc Health Care 1980;1:178.Crossref 15. Parker CR, Ellegood JO, Mahesh VB: Methods for multiple steroid radioimmunoassay . J Steroid Biochem 1975;6:1-8.Crossref 16. Mills TM, Lin TJ, Braselton WE, et al: Metabolism of oral contraceptive drugs: The formulation and disappearance of metabolites of norethindrone and mestranol after intravenous and oral administration . Am J Obstet Gynecol 1976;126:987-996. 17. Mahesh VB, Mills TM, Lin TJ, et al: Metabolism, metabolic clearance rate of blood metabolites, and blood half-life of norethindrone and mestranol , in Garratini S, Berendes HW (eds): Pharmacology of Steroid Contraceptive Drugs . New York, Raven Press, 1977, pp 117-130. 18. Nie NH, Hull CH, Jenkins JT, et al: Statistical Package for the Social Sciences , ed 2. New York, McGraw-Hill Book Co, 1975. 19. Haynes RB, Taylor DW, Snow JC, et al: Annotated and indexed bibliography on compliance with therapeutic and preventive regimens , in Haynes RB, Taylor DW, Sackett DL (eds): Compliance in Health Care . Baltimore, The Johns Hopkins University Press, 1979, pp 337-474. 20. Camfield C, Chaplin S, Doyle AB, et al: Side effects of phenobarbital in toddlers: Behavioral and cognitive aspects . J Pediatr 1979;95: 361-365.Crossref 21. Sanpitak N, Chayutimonkul L: Oral contraceptives and riboflavin nutrition . Lancet 1974;1:836-837.Crossref 22. Newman LJ, Lopez R, Choe HS: Riboflavin deficiency in women taking oral contraceptive agents . Am J Clin Nutr 1978;31:247-249. 23. Gershwin MI, Steinberg AD: Oral contraceptives and vitamin nutrients . Lancet 1974;1: 1234-1235. 24. Wynn V: Vitamins and oral contraceptive use . Lancet 1975;1:561-564.Crossref 25. Jusko WJ, Levy G: Absorption, protein binding, and elimination of riboflavin , in Rivlin RS (ed): Riboflavin . New York, Plenum Press, 1975, pp 99-152. 26. Jusko WJ, Levy G: Absorption, metabolism, and excretion of riboflavin 51-phosphate in man . J Pharm Sci 1967;56:58-61.Crossref 27. Jusko WJ, Khanna N, Levy G, et al: Riboflavin absorption and excretion in the neonate . Pediatrics 1970;45:945-949. 28. Jay S, DuRant RH, Shoffitt T, et al: The effect of peer counselors on adolescent compliance with oral contraceptives. Pediatrics, in press. 29. DuRant RH, Jay S, Linder CW, et al: The influence of psychosocial factors on adolescent compliance with oral contraceptives. J Adolesc Health Care, in press.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jan 1, 1984

References