Use of prescription contraceptive methods in the UK general population: a primary care study

BJOG. 2014 Jan;121(1):53-60; discussion 60-1. doi: 10.1111/1471-0528.12465. Epub 2013 Oct 1.

Abstract

Objective: To determine prescription contraceptive use in the UK.

Design: Observational study using a primary care database.

Setting: The Health Improvement Network (THIN).

Population: Women in THIN aged 12-49 years in 2008, registered with their primary care doctor for at least 5 years, and with a prescription history of at least 1 year were included.

Methods: THIN was searched using the Read and MULTILEX codes for the following methods: combined oral contraceptives (COCs), progestogen-only pills (POPs), copper intrauterine devices (Cu-IUDs), the levonorgestrel-releasing intrauterine system (LNG-IUS), progestogen-only implants, progestogen-only injections, and contraceptive patches.

Main outcome measures: Prevalence, switching, and duration of prescriptions.

Results: A cohort of 194 054 women was identified. The prevalence of contraceptive use was: COCs, 16.2% (95% confidence interval, 95% CI 16.1-16.3%); POPs, 5.6% (95% CI 5.5-5.6%); Cu-IUD, 4.5% (95% CI 4.4-4.5%); LNG-IUS, 4.2% (95% CI 4.1-4.2%); progestogen-only implants, 1.5% (95% CI 1.5-1.6%); progestogen-only injections, 2.4% (95% CI 2.3-2.4%); and contraceptive patches, 0.1% (95% CI 0.1-0.2%). Within 1 year, 9.8% of new COC users switched to alternative COCs, and 9.0% changed to a different method. Among new COC users who did not switch method, 34.8% did not continue use beyond 3 months, and were no longer using a prescription contraceptive.

Conclusions: Among users of oral contraceptives who did not switch method, over one-third did not continue use beyond 3 months. This supports current UK guidelines recommending a follow-up consultation with a healthcare professional 3 months after the first prescription of COCs.

Keywords: Contraceptives; The Health Improvement Network; UK; discontinuation; prevalence; switching.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Contraceptives, Oral / therapeutic use
  • Contraceptives, Oral, Combined / therapeutic use*
  • Drug Implants / therapeutic use
  • Female
  • Humans
  • Intrauterine Devices, Copper / statistics & numerical data*
  • Intrauterine Devices, Medicated / statistics & numerical data
  • Middle Aged
  • Primary Health Care*
  • Progestins / therapeutic use*
  • Transdermal Patch / statistics & numerical data*
  • United Kingdom
  • Young Adult

Substances

  • Contraceptives, Oral
  • Contraceptives, Oral, Combined
  • Drug Implants
  • Progestins