Oral Contraceptive Preference and Prescription Patterns Among Primary Care Residents in an Academic Medical Center [1F

Abstract

INTRODUCTION: Oral contraceptive pills (OCPs) are the most widely-used form of reversible contraception in the United States. There are a variety of formulations available with little evidence in the literature on which to recommend over another. This study analyzes OCP prescription patterns among primary care residents within the University of California Los Angeles (UCLA) Health System. METHODS: An IRB-approved cross-sectional survey was administered electronically to residents in three primary care specialties (family medicine, internal medicine, obstetrics and gynecology). The survey contained questions analyzing frequency of OCP prescription, as well as attitudes and practices regarding prescription of OCP formulations. Data analysis was performed using univariate statistics. RESULTS: Survey response rate is 34% with 52 completed surveys. 52% of respondents reported prescribing up to 5 OCPs per week. A majority of residents (85%) demonstrated understanding of the pharmacological and clinical equivalences between generic and branded OCPs. However only 35% of residents felt comfortable helping patients choose an appropriate OCP or counseling patients on choices between generic versus branded pills. More than half of the respondents (62%) did not feel comfortable managing breakthrough bleeding with the use of OCPs. When asked to choose a “preferred” formulation, residents tended to choose a monophasic (72%), combined hormonal (92%), generic (72%) oral contraceptive pill. CONCLUSION: There is extensive redundancy of OCP formulations on the market. Improving knowledge of OCP prescription preferences is essential to clarifying common practices among physicians. Curriculum for primary care residents should elucidate the differences between formulations of OCPs, types of progestins, and relative side effects.