Prescribing patterns of combined hormonal products containing cyproterone acetate, levonorgestrel and drospirenone in the UK. Issue 4 (20th April 2016)

• Record Type: Journal Article
• Authors: Cea-Soriano, Lucía; Wallander, Mari-Ann; García Rodríguez, Luis Alberto
• Is Part Of: Journal of family planning and reproductive health care. Volume 42:Issue 4(2016)
• Page Start: 247
• Page End: 254
• Publication Date: 2016-04-20
• Subjects: hormonal contraception -- cyproterone acetate -- levonorgestrel -- drospirenone -- prescribing -- pharmacoepidemiology; Birth control -- Periodicals; Contraception -- Periodicals; Reproductive health -- Periodicals; 613.905
• DOI: 10.1136/jfprhc-2015-101202
• Languages: English
• ISSNs: 1471-1893

Abstract

Abstract : Background: There are limited data to show the levels of prescribing of combined oral contraceptives (COCs) and other hormonal products containing estrogen/progestogen combinations that may be outside the product licence. Aims: To determine the diagnosis/indication recorded at the time of prescription of cyproterone acetate/ethinylestradiol (CPA/EE) and two COCs, levonorgestrel/EE (LNG/EE) and drospirenone/EE (DRSP/EE). Design and setting: Retrospective study using a primary care database, The Health Improvement Network (THIN). Methods: Women in THIN aged 12–49 years prescribed CPA/EE, LNG/EE or DRSP/EE in 2002–2010 were identified. Overall use of each product and proportion of new users each year were determined. Among new users, database codes were analysed to infer the reason for prescription. Results: The proportion of new users of each product in 2002 and 2010, respectively, were: LNG/EE, 2.03% and 2.40%; CPA/EE, 0.45% and 0.27%; and DRSP/EE, 0.27% and 0.56%. Most new users prescribed CPA/EE had a record of acne (51.0% and 79.2% in 2002 and 2010, respectively) or hirsutism (3.0% and 5.0% in 2002 and 2010, respectively); the proportion of new users with a record only for contraception decreased from 32.9% in 2002 to 8.6% in 2010. Among new users prescribed DRSP/EE or LNG/EE in 2010, 43.2% and 30.8% of women, respectively, did not have a record indicating use for contraception. Conclusions: Adherence to prescribing guidelines for CPA/EE has improved over time. A substantial proportion of women using DRSP/EE or LNG/EE had records for hormone-responsive conditions only, suggesting that many women were prescribed these therapies for non-contraceptive use.