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Keywords:

  • Contraceptives;
  • discontinuation;
  • prevalence;
  • switching;
  • The Health Improvement Network;
  • UK

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.