Cargando…

Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005–2010

OBJECTIVE: To investigate if continuation rates in first-time users of oral hormonal contraceptives differed between different formulations and to measure if the rates were related to the prescribing categories, that is, physicians and midwives. DESIGN: A longitudinal national population-based regis...

Descripción completa

Detalles Bibliográficos
Autores principales: Josefsson, Ann, Wiréhn, Ann-Britt, Lindberg, Malou, Foldemo, Anniqa, Brynhildsen, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808784/
https://www.ncbi.nlm.nih.gov/pubmed/24141970
http://dx.doi.org/10.1136/bmjopen-2013-003401
_version_ 1782288630495051776
author Josefsson, Ann
Wiréhn, Ann-Britt
Lindberg, Malou
Foldemo, Anniqa
Brynhildsen, Jan
author_facet Josefsson, Ann
Wiréhn, Ann-Britt
Lindberg, Malou
Foldemo, Anniqa
Brynhildsen, Jan
author_sort Josefsson, Ann
collection PubMed
description OBJECTIVE: To investigate if continuation rates in first-time users of oral hormonal contraceptives differed between different formulations and to measure if the rates were related to the prescribing categories, that is, physicians and midwives. DESIGN: A longitudinal national population-based registry study. SETTING: The Swedish prescribed drug register. PARTICIPANTS: All women born between 1977 and 1994 defined as first-time users of hormonal contraceptives from 2007 to 2009 (n=226 211). MAIN OUTCOME MEASURES: A tendency to switch the type of hormonal contraceptive within 6 months use and repeated dispensation identical to the first were estimated as percentages and relative risks (RRs). Physicians’ and midwives’ prescription patterns concerning the women's continuation rates of oral hormonal contraceptive type. RESULTS: In Sweden, there were 782 375 women born between 1977 and 1994 at the time of the study. Of these, 226 211 women were identified as first-time users of hormonal contraceptives. Ethinylestradiol+levonorgestrel, desogestrel-only and ethinylestradiol+drospirenone were the hormonal contraceptives most commonly dispensed to first-time users at rates of 43.3%, 24.4% and 11.1%, respectively. The overall rate of switching contraceptive types in the first 6 months was 11.3%, which was highest for desogestrel-only (14.3%) and lowest for ethinylestradiol+drospirenone (6.6%). The switching rate for all three products was highest in the 16-year to 19-year age group. Having a repeated dispensation identical to the initial dispensation was highest for users of ethinylestradiol either combined with levonorgestrel or drospirenone, 81.4% and 81.2%, respectively, whereas this rate for the initial desogestrel-only users was 71.5%. The RR of switching of contraceptive type within the first 6 months was 1.35 (95% CI 1.32 to 1.39) for desogestrel-only and 0.63 (0.59 to 0.66) for ethinylestradiol+drospirenone compared with ethinylestradiol+levonorgestrel as the reference category. There were no differences in the women's continuation rates depending on the prescriber categories. CONCLUSIONS: Desogestrel-only users conferred the highest switcher rate to another hormonal contraceptive within a 6-month period. Users of ethinylestradiol+levonorgestrel were more prone to switch to another product within 6 months than women using ethinylestradiol+drospirenone. These findings may be of clinical importance when tailoring hormonal contraceptives on an individual basis.
format Online
Article
Text
id pubmed-3808784
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-38087842013-10-29 Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005–2010 Josefsson, Ann Wiréhn, Ann-Britt Lindberg, Malou Foldemo, Anniqa Brynhildsen, Jan BMJ Open Obstetrics and Gynaecology OBJECTIVE: To investigate if continuation rates in first-time users of oral hormonal contraceptives differed between different formulations and to measure if the rates were related to the prescribing categories, that is, physicians and midwives. DESIGN: A longitudinal national population-based registry study. SETTING: The Swedish prescribed drug register. PARTICIPANTS: All women born between 1977 and 1994 defined as first-time users of hormonal contraceptives from 2007 to 2009 (n=226 211). MAIN OUTCOME MEASURES: A tendency to switch the type of hormonal contraceptive within 6 months use and repeated dispensation identical to the first were estimated as percentages and relative risks (RRs). Physicians’ and midwives’ prescription patterns concerning the women's continuation rates of oral hormonal contraceptive type. RESULTS: In Sweden, there were 782 375 women born between 1977 and 1994 at the time of the study. Of these, 226 211 women were identified as first-time users of hormonal contraceptives. Ethinylestradiol+levonorgestrel, desogestrel-only and ethinylestradiol+drospirenone were the hormonal contraceptives most commonly dispensed to first-time users at rates of 43.3%, 24.4% and 11.1%, respectively. The overall rate of switching contraceptive types in the first 6 months was 11.3%, which was highest for desogestrel-only (14.3%) and lowest for ethinylestradiol+drospirenone (6.6%). The switching rate for all three products was highest in the 16-year to 19-year age group. Having a repeated dispensation identical to the initial dispensation was highest for users of ethinylestradiol either combined with levonorgestrel or drospirenone, 81.4% and 81.2%, respectively, whereas this rate for the initial desogestrel-only users was 71.5%. The RR of switching of contraceptive type within the first 6 months was 1.35 (95% CI 1.32 to 1.39) for desogestrel-only and 0.63 (0.59 to 0.66) for ethinylestradiol+drospirenone compared with ethinylestradiol+levonorgestrel as the reference category. There were no differences in the women's continuation rates depending on the prescriber categories. CONCLUSIONS: Desogestrel-only users conferred the highest switcher rate to another hormonal contraceptive within a 6-month period. Users of ethinylestradiol+levonorgestrel were more prone to switch to another product within 6 months than women using ethinylestradiol+drospirenone. These findings may be of clinical importance when tailoring hormonal contraceptives on an individual basis. BMJ Publishing Group 2013-10-18 /pmc/articles/PMC3808784/ /pubmed/24141970 http://dx.doi.org/10.1136/bmjopen-2013-003401 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Obstetrics and Gynaecology
Josefsson, Ann
Wiréhn, Ann-Britt
Lindberg, Malou
Foldemo, Anniqa
Brynhildsen, Jan
Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005–2010
title Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005–2010
title_full Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005–2010
title_fullStr Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005–2010
title_full_unstemmed Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005–2010
title_short Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 2005–2010
title_sort continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, sweden 2005–2010
topic Obstetrics and Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808784/
https://www.ncbi.nlm.nih.gov/pubmed/24141970
http://dx.doi.org/10.1136/bmjopen-2013-003401
work_keys_str_mv AT josefssonann continuationratesoforalhormonalcontraceptivesinacohortoffirsttimeusersapopulationbasedregistrystudysweden20052010
AT wirehnannbritt continuationratesoforalhormonalcontraceptivesinacohortoffirsttimeusersapopulationbasedregistrystudysweden20052010
AT lindbergmalou continuationratesoforalhormonalcontraceptivesinacohortoffirsttimeusersapopulationbasedregistrystudysweden20052010
AT foldemoanniqa continuationratesoforalhormonalcontraceptivesinacohortoffirsttimeusersapopulationbasedregistrystudysweden20052010
AT brynhildsenjan continuationratesoforalhormonalcontraceptivesinacohortoffirsttimeusersapopulationbasedregistrystudysweden20052010