Abstract
BackgroundUnplanned pregnancy is a significant problem in Australia. Local data pertaining to use of the levonorgestrel-releasing intra-uterine device (LNG-IUD), and associated factors are limited. The aim of this analysis was to calculate prescribing rates of the LNG-IUD in Australia, including trends in prescribing and associations with socio-demographic factors, in order to increase understanding regarding potential use.MethodsWe examined prescriptions for the LNG-IUD recorded in the national Pharmaceutical Benefits Scheme (PBS) from 2008 to 2012. Prescribing trends were examined according to patient age, remoteness of residential location, and proximity to relevant specialist health services. Associations between these factors and prescription rates were examined using poisson regression. Analyses were stratified by 5-year age-groups.ResultsAge-adjusted prescription rates rose from 11.50 per 1000 women aged 15–49 (95% CI: 11.41–11.59) in 2008 to 15.95 (95% CI:15.85–16.01) in 2012. Prescription rates increased most among 15–19-year-olds but remain very low at 2.76 per 1000 women (95% CI: 2.52–3.01). Absolute increases in prescriptions were greatest among 40–44-year-olds, rising from 16.73 per 1000 women in 2008 (95% CI: 16.12–17.34) to 23.77 in 2012 (95% CI: 22.58–24.29). Rates increased significantly within all geographical locations (p < 0.01). Non-metropolitan location was significantly associated with increased prescribing rates, the association diminishing with increasing age groups.ConclusionsPrescription of LNG-IUD in Australia is very low, especially among young women and those in major cities. Service providers and young women may benefit from targeted education outlining use of the LNG-IUD, strengthened training and referral pathways. Disparities in prescription according to location require further investigation.
Highlights
The levonorgestrel-releasing intrauterine device (LNG-Intrauterine device (IUD)) is a highly effective long-acting reversible contraceptive (LARC)
Use of the levonorgestrel-releasing intra-uterine device (LNG-IUD) and other IUDs remains low in Australia: limited data suggest that IUDs are used by between 3.2 and 6.1% of contracepting women, and by as few as 1.7% of women of reproductive age in Australia and New Zealand [5,6,7]
Design & setting This cross-sectional time-series analysis utilises a dataset of the number of prescriptions for the LNG-IUD through the Pharmaceutical Benefits Scheme (PBS), obtained from the Department of Human Services for the maximum period available which ran from March 2008 to December 2012, inclusive
Summary
The levonorgestrel-releasing intrauterine device (LNG-IUD) is a highly effective long-acting reversible contraceptive (LARC). While shorter-acting contraceptives such as the oral contraceptive pill require high levels of patient compliance to maintain effectiveness, the LNG-IUD is effective for up to 5 years, with a first-year failure rate similar to that of sterilisation (0.2%) [1]. It is cost-effective and suitable for the vast majority of women [1, 2]. Local data pertaining to use of the levonorgestrel-releasing intra-uterine device (LNG-IUD), and associated factors are limited The aim of this analysis was to calculate prescribing rates of the LNG-IUD in Australia, including trends in prescribing and associations with socio-demographic factors, in order to increase understanding regarding potential use
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