Use of prescribed contraception in Northern Ireland 2010–2016

Abstract

Objective: To describe the use of prescribed contraceptives in Northern Ireland (NI) and how this varies with a woman's age, the deprivation in the area in which she lives and characteristics of her General Practice (GP). Method: A population-based cohort study was conducted including 560,074 females, aged 12-49 registered with a GP (2010-2016), contributing 3,255,500 woman-years of follow-up. Dispensed contraceptive prescriptions were linked to demographic details. Results: A contraceptive prescription was dispensed in 26.2% of woman-years with women aged 20-24 most likely to have a contraceptive dispensed (45.7% of woman-years). After adjusting for patient and other practice characteristics, practices in the least deprived quintile prescribed 6% more contraception than those in the most deprived quintile. The combined oral contraceptives (16.6% of woman-years) and progesterone only pill (8.0% of woman-years) were the most commonly dispensed methods. Patient and practice level characteristics were found to be related to the specific contraceptive methods dispensed which also changed during the time frame of the study. Conclusions: This is the first population-based assessment of contraceptive prescription in NI. It is useful for health service planning and to inform broader reproductive policy debates. The impact of practice area-based deprivation, above that of the woman's residence, on contraceptive dispensing is a new finding that deserves more exploration.

Low-income women and use of prescribed contraceptives in the context of full health insurance coverage in France, 2019

“…Our results are in line with a US study showing that use of contraception only slightly increased when implementing a program (Medicaid) with free access to contraceptives for low-income women [11]. Despite free access to contraception, lower use of contraception was also observed among women living in socioeconomically disadvantaged areas in the United Kingdom [5] but not in Northern Ireland [12]. A few other studies have explored socioeconomic differences in contraception use [11,13,14] but in these works, copper IUDs, the LNG-IUS, and implants were grouped together as long-acting reversible contraceptives (LARC).…”

Socioeconomic and Cultural Factors Influencing Type of Hormonal Contraceptive Use in Women in Developed vs Under-Developed Geographic Areas

“…Conversely, within the contraceptive landscape of Northern Ireland, a distinct shift is noted in prescription patterns from 2010 to 2016 [25]. During this period, there was a reduction of 12% in the dispensing of COCP, 6% in contraceptive injections, and 5% in emergency contraception.…”

“…In the developed regions of the United Kingdom, such as Scotland and its counterparts, there exists minimal variance in the prescription patterns of contraceptives across urban and rural healthcare facilities, as well as among practices of varying sizes [25]. Notably, discernible trends emerge in prescription practices concerning socioeconomic factors.…”

“…Within regions characterized by lower levels of socioeconomic deprivation, medical practices exhibit reduced rates of prescribing implants by 19%, transdermal patches by 16%, and an elevated prescription rate of progestin-only pills by 9% compared to their counterparts in the most deprived quintiles [25]. The predominant form of contraception prescribed in these areas remains COCP, with a marginal increase observed from 17.7% in 2004-2005 to 18.3% in 2008-2009.…”

Time trends in contraceptive prescribing in UK primary care 2000–2018: a repeated cross-sectional study

“…[14][15][16][17] We observed comparable estimates of prescribing to a population-based Northern Irish study for the period 2010-2016 (20.2% vs 16.6% for COCPs and 9.4% vs 8.0% for POPs). 18 The small difference could be explained by the fact that these researchers were unable to link 11% of dispensed contraceptives to individuals and these were not included. In comparison to a Clinical Practice Research Datalink study focusing on the impact of QOF on LARC uptake for the period 2004-2014, our estimates of LARC prescribing were higher (5.7% vs 3.0% for 2009 and 6.7% vs 3.9% for 2014).…”