Prescriptive contraceptive use among isotretinoin users in the Netherlands in comparison with non-users: a drug utilisation study.
OBJECTIVE
To assess the compliance with the isotretinoin Pregnancy Prevention Programme (PPP) by evaluating the use of prescribed contraceptives among isotretinoin users. The PPP contains a requirement for the use of contraceptive methods for women of childbearing potential.


METHODS
A drug utilisation study was performed using data from a drug prescription database (containing Dutch community pharmacy data) covering a population of 500 000 patients. Contraceptive use in female isotretinoin users and in a reference group of female non-isotretinoin users (aged 15-49 years) was compared using data from 1999 until 2006 in 2-year periods. Descriptive statistics were used.


RESULTS
Of the female isotretinoin users (n = 651), 52%-54% filled prescriptions on contraceptives in strict accordance to the PPP, used before, during, and after discontinuation of isotretinoin, compared with 39%-46% in the reference group. A more liberal approach of a minimum of one prescription for a contraceptive method showed 61%-64% use of contraceptives among isotretinoin users. Similar patterns were seen when data were broken down in age groups. Furthermore, a higher proportion of female patients using isotretinoin prescribed by general practitioners used prescribed contraceptives compared with those receiving isotretinoin by specialists.


CONCLUSIONS
Compliance with the contraceptive use according to a PPP for a teratogenic drug such as isotretinoin is 52%-64%, which is lower than anticipated. Reasons for the low compliance will need to be clarified before further measures can be taken.
University of Groningen, Department of Pharmacoepidemiology & Pharmacoeconomics, Groningen, the Netherlands. hj.crijns@cbg-meb.nl
Hubertina J M J
HJ
Crijns
Nienke
N
van Rein
Christine C
CC
Gispen-de Wied
Sabine M
SM
Straus
Lolkje T W
LT
de Jong-van den Berg
D000014:Abnormalities, Drug-Induced / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D003270:Contraceptive Agents; D000075202:Contraindications; D003879:Dermatologic Agents; D005260:Female; D006801:Humans; D015474:Isotretinoin; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D055656:Prescriptions / Q000706:statistics & numerical data*
D003270:Contraceptive Agents; D003879:Dermatologic Agents; D015474:Isotretinoin