Trends and patterns of hormonal contraceptive prescribing for adolescents in primary care in the UK

Abstract

BackgroundHormonal contraceptives are the most common method used worldwide by teenagers to prevent unwanted pregnancies. To date there are limited data about such use by teenagers in the UK. This study investigated trends and patterns of hormonal contraceptive prescribing to adolescents aged 12–18 years in UK primary care between 2002 and 2011.MethodsA retrospective cohort study using the IMS Disease Analyzer database was conducted. All females aged 12–18 years with ≥1 prescription for a contraceptive drug between 1 January 2002 and 31 December 2011 were included. Annual prevalence of contraceptive drug prescribing was calculated, and indications for prescribing, and types of contraceptive drug prescribed, were examined.ResultsIn 2002, 13.7% (6135/44 532) of female adolescents received prescriptions for hormonal contraceptives, compared to 19.0% (6597/34 676) in 2011. The majority of female adolescents [2002: 76.2% (4676/6135); 2011: 65.7% (4334/6597)] received a contraceptive drug for ‘contraceptive management’. The combined oral contraceptive (COC), ‘progestogen+estrogen’, was the most commonly prescribed. Although use of progestogen-only contraceptives was lower than COCs, the number of patients who received desogestrel pills and etonogestrel implants increased during the study period; levonorgestrel pill use declined. Only one injectable progestogen, long-acting depot medroxyprogesterone acetate, was prescribed.ConclusionsUse of hormonal contraceptives among adolescents increased between 2002 and 2011, and COC usage was dominant. The increasing use of hormonal contraceptives in adolescents, especially in younger adolescents, warrants further investigation, including research into the long-term safety of these medicines in this age group.

Adherence to no-cost oral contraceptives among active-duty servicewomen

“…We lack the information to differentiate between intentional discontinuation and erratic filling. We also lack information regarding the medical indication for OC use, even though previous studies have shown that among this age group the majority are prescribed OC for contraception as opposed to other indications 33. In other studies11 24 also, adherence of OC was assessed but the indication for OC prescription was not mentioned.…”

Poisson regression

“…Not surprisingly, given the graph, the null hypothesis of no difference between prescription rates for older and younger teenagers can be rejected ( p <0.001, Results paragraph 1). In Figure 1 the increase in prescribing across years appears to have been modest,1 and no p value is reported, so presumably there was no statistically significant difference across calendar years.…”

“…historical time, i.e. years 2002 to 2011)1 or between specific subgroup characteristics (e.g. younger and older teenagers) 1.…”

“…years 2002 to 2011)1 or between specific subgroup characteristics (e.g. younger and older teenagers) 1. It can also be used to control for confounding, and to provide population estimates [with confidence intervals (CIs)].…”

“…Figure 1 in the Rashed et al article shows the estimates (with CIs) that were obtained for rates of prescription for contraception by calendar year for the two teenage subgroups 1. The model has also been used to compare prescription rates between the two teenage subgroups, combined across calendar years.…”