title: Prescription rates of the contraceptive implant in Australia 2008-2012: impact of patient age and area of residence.
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.
  
  
  
  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).
  
  
  
  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.
  
  
  
  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.
authors.affiliation: 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.
authors.forename: Amie L
authors.initials: AL
authors.lastname: Bingham
authors.affiliation: 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.
authors.forename: Cameryn C
authors.initials: CC
authors.lastname: Garrett
authors.affiliation: 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.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Kavanagh
authors.affiliation: 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.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Keogh
authors.affiliation: 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.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Bentley
authors.affiliation: Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, 207 Bouverie Street, University of Melbourne, Melbourne, Vic. 3010, Australia.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Hocking
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D001315:Australia; D003267:Contraception; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D017135:Desogestrel / Q000008:administration & dosage*; D004343:Drug Implants; D005193:Family Planning Services; D005260:Female; D006801:Humans; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants; C044815:etonogestrel; D017135:Desogestrel