Prescription rates of the contraceptive implant in Australia 2008–2012: impact of patient age and area of residence
Amie L. Bingham A C , Cameryn C. Garrett A , Anne M. Kavanagh A , Louise A. Keogh A , Rebecca J. Bentley A and Jane S. Hocking BA Gender & Women’s Health Unit, Centre for Health Equity, Melbourne School of Population & Global Health, 207 Bouverie Street, University of Melbourne, Melbourne, Vic. 3010, Australia.
B Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, 207 Bouverie Street, University of Melbourne, Melbourne, Vic. 3010, Australia.
C Corresponding author. Email: binghama@unimelb.edu.au
Sexual Health 13(1) 87-90 https://doi.org/10.1071/SH15141
Submitted: 27 April 2015 Accepted: 18 September 2015 Published: 23 November 2015
Abstract
Background: Long-acting reversible contraceptives are an effective means of preventing unwanted pregnancies and associated negative consequences. The Sexual Health and Family Planning Association of Australia has called for efforts to address barriers to the uptake of long-acting reversible contraceptives (LARCs) in Australia, where LARC uptake is thought to be low, though comprehensive data describing use and associated factors is scarce. The aims of this study were to describe patterns of prescriptions for the etonogestrel-releasing subdermal implant (SDI) in Australia, 2008–2012, and associated factors. Methods: Records of prescriptions written through Australia’s Pharmaceutical Benefits Scheme from 2008 to 2012 were obtained, including patient age and geographic location. Direct, age-standardised rates (ASR) of prescriptions were calculated for each year and location, with multivariate analysis used to examine associations between prescription rates and patient age, location and proximity to family planning clinics (FPC) or Aboriginal Medical Services (AMS). Results: ASR of prescriptions rose ~6% per year (OR 1.06, 95%CI: 1.05–1.06) from 13.05 per 1000 (2008) to 15.76 per 1000 (2012; P < 0.01). Rates were highest among 15- to 19-year-olds, increasing from 20.81 (2008) to 29.09 per 1000 (2012: P < 0.01) and lowest among 45- to 49-year-olds, increasing from 3.37 to 3.73 per 1000 (P < 0.01). ASR by location were significantly higher in regional than metropolitan areas. Conclusions:This is the first analysis of SDI prescriptions across all ages and regions of Australia. Uptake of SDI in Australia is increasing but remains low. Significant associations were found between prescription rates and patient age and residence in regional/remote areas.
References
[1] Stoddard A, McNicholas C, Peipert JF. Efficacy and safety of long-acting reversible contraception. Drugs 2011; 71 969–80.| Efficacy and safety of long-acting reversible contraception.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXhtVWmsrnI&md5=6153d5145bc3d6777bf520e113b1e91eCAS | 21668037PubMed |
[2] Winner B, Peipert JF, Zhao Q, Buckel C, Madden T, Allsworth JE, Secura GM. Effectiveness of long-acting reversible contraception. N Engl J Med 2012; 366 1998–2007.
| Effectiveness of long-acting reversible contraception.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XotVynsL4%3D&md5=d814387c7f42f7edbc6f6142e5cfc8bfCAS | 22621627PubMed |
[3] Lipetz C, Phillips CJ, Fleming CF. The cost-effectiveness of a long-acting reversible contraceptive (Implanon®) relative to oral contraception in a community setting. Contraception 2009; 79 304–9.
| The cost-effectiveness of a long-acting reversible contraceptive (Implanon®) relative to oral contraception in a community setting.Crossref | GoogleScholarGoogle Scholar | 19272500PubMed |
[4] Ong J, Temple-Smith M, Wong W, McNamee K, Fairley CK. Contraception matters: indicators of poor usage of contraception in sexually active women attending family planning clinics in Victoria, Australia. BMC Public Health 2012; 12 1108
| Contraception matters: indicators of poor usage of contraception in sexually active women attending family planning clinics in Victoria, Australia.Crossref | GoogleScholarGoogle Scholar | 23259407PubMed |
[5] Haimovich S. Profile of long-acting reversible contraception users in Europe. Eur J Contracept Reprod Health Care 2009; 14 187–95.
| Profile of long-acting reversible contraception users in Europe.Crossref | GoogleScholarGoogle Scholar | 19565416PubMed |
[6] Eeckhaut MC, Sweeney MM, Gipson JD. Who is using long-acting reversible contraceptive methods? Findings from nine low-fertility countries. Perspect Sex Reprod Health 2014; 46 149–55.
| Who is using long-acting reversible contraceptive methods? Findings from nine low-fertility countries.Crossref | GoogleScholarGoogle Scholar | 25040454PubMed |
[7] Gray E, Arnunachalam D. Patterns of contraceptive use. HILDA Survey Research Conference 2013. Available online at: http://www.melbourneinstitute.com/downloads/conferences/HILDA_2013/HILDA_2013_papers/Gray,%20Edith_final%20paper.pdf [verified 2 February 2015].
[8] Sexual Health & Family Planning Australia. Time for a change: increasing the use of long acting reversible contraceptive methods in Australia: a statement from Sexual Health and Family Planning Australia 2013. Available online at: http://www.shfpa.org.au/sites/shfpa.drupalgardens.com/files/201310/LARCstatementSHFPAFINAL.pdf [verified 28 October 2013].
[9] National Institutes for Health and Clinical Excellence. Long-acting reversible contraception: NICE Guidelines CG30. Available online at: https://www.nice.org.uk/guidance/cg30 [verified 12 October 2015].
[10] Lucke JC, Watson M, Herbert D. Changing patterns of contraceptive use in Australian women. Contraception 2009; 80 533–9.
| Changing patterns of contraceptive use in Australian women.Crossref | GoogleScholarGoogle Scholar | 19913147PubMed |
[11] Gray E, McDonald P. Using a reproductive life course approach to understand contraceptive method use in Australia. J Biosoc Sci 2010; 42 43–57.
| Using a reproductive life course approach to understand contraceptive method use in Australia.Crossref | GoogleScholarGoogle Scholar | 19852866PubMed |
[12] Secura GM, Allsworth JE, Madden T, Mullersman JL, Peipert JF. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol 2010; 203 115.e1–e7.
| The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception.Crossref | GoogleScholarGoogle Scholar |
[13] Greenberg KB, Makino KK, Coles MS. Factors associated with provision of long-acting reversible contraception among adolescent health care providers. J Adolesc Health 2013; 52 372–4.
| Factors associated with provision of long-acting reversible contraception among adolescent health care providers.Crossref | GoogleScholarGoogle Scholar | 23427785PubMed |
[14] Harvey C, Seib C, Lucke J. Continuation rates and reasons for removal among Implanon® users accessing two family planning clinics in Queensland, Australia. Contraception 2009; 80 527–32.
| Continuation rates and reasons for removal among Implanon® users accessing two family planning clinics in Queensland, Australia.Crossref | GoogleScholarGoogle Scholar | 19913146PubMed |
[15] Lucke J, Herbert D. Higher uptake of LARC and permanent contraceptive methods by Australian women living in rural and remote areas. Aust N Z J Public Health 2014; 38 112–6.
| Higher uptake of LARC and permanent contraceptive methods by Australian women living in rural and remote areas.Crossref | GoogleScholarGoogle Scholar | 24690048PubMed |
[16] Marie Stopes International. Real choices: women, contraception and unplanned pregnancy. 2008. Available online at: http://www.mariestopes.org.au/images/stories/libraryfiles/Real-Choices-Key-Findings.pdf [verified 2 December 2013].
[17] Weisberg E, Bateson D, Read C, Estoesta J, Lee C. Fertility control? Middle-aged Australian women’s retrospective reports of their pregnancies. Aust N Z J Public Health 2008; 32 390–2.
| Fertility control? Middle-aged Australian women’s retrospective reports of their pregnancies.Crossref | GoogleScholarGoogle Scholar | 18782406PubMed |
[18] Australian Bureau of Statistics. Australian Statistical Geography Standard (ASGS): volume 1 – main structure and Greater Capital City Statistical Areas. Cat. no: 1270.0.55.001. Canberra: Australian Bureau of Statistics; 2011.
[19] Sexual Health & Family Planning Australia. Sexual health & family planning Australia. Available online at: http://www.shfpa.org.au/ [verified 03 October 2013].
[20] National Aboriginal Community Controlled Health Organisation. Affiliates. Available online at: http://www.naccho.org.au/about-us/affiliates/ [verified 03 October 2013].
[21] Australian Bureau of Statistics. Population estimates by age and sex, Australia by Statistical Geography, 2001 to 2011, data cube: SuperTABLE. Cat. no. 32350.0 [database on the Internet]; 2011. Available online at: http://www.abs.gov.au/ausstats/abs@.nsf/web+pages/Citing+ABS+Sources#Data%20cubes [verified 22 August 2013].
[22] Drug Utilisation Sub-Committee of the Pharmaceutical Benefits Advisory Committee. Australian statistics on medicines. Australian Government, Department of Health. Available online at: http://www.pbs.gov.au/info/browse/statistics#ASM [cited 15 January 2015].
[23] Quine S, Bernard D, Booth M,, Kang M, Usherwood T, Alperstein G, Bennett D. Health and access issues among Australian adolescents: a rural-urban comparison. Rural Remote Health 2003; 3 245
| 1:STN:280:DC%2BD2M3ksFaquw%3D%3D&md5=fe69a2227139ffd902bee881cfd93061CAS | 15882102PubMed |
[24] Sheil W, Scott J, Catcheside B, Sage L, Kennare R. Pregnancy outcome in South Australia 2011. Adelaide: Pregnancy Outcome Unit, SA Health, Government of South Australia; 2013.
[25] Hutchinson M, Joyce A, Cheong M. Induced abortions in Western Australia 2010 – 2012. 4th report of the Western Australian Abortion Notification System. Department of Health, Western Australia; 2013. Available online at: https://www.health.wa.gov.au/publications/documents/Abortion_Report_2010-12.pdf [verifed 12 October 2015].
[26] National Institutes for Health and Clinical Excellence. NICE implementation uptake report: Long-acting reversible contraception (LARC). 2010. Available at: http://www.nice.org.uk/media/67F/C5/UptakeReportCG30LARC.pdf [verified 28 January 2014].
