Prescribing patterns of combined hormonal products containing cyproterone acetate, levonorgestrel and drospirenone in the UK.
BACKGROUND
There are limited data to show the levels of prescribing of combined oral contraceptives (COCs) and other hormonal products containing estrogen/progestogen combinations that may be outside the product licence.


OBJECTIVE
To determine the diagnosis/indication recorded at the time of prescription of cyproterone acetate/ethinylestradiol (CPA/EE) and two COCs, levonorgestrel/EE (LNG/EE) and drospirenone/EE (DRSP/EE).


METHODS
Retrospective study using a primary care database, The Health Improvement Network (THIN).


METHODS
Women in THIN aged 12-49 years prescribed CPA/EE, LNG/EE or DRSP/EE in 2002-2010 were identified. Overall use of each product and proportion of new users each year were determined. Among new users, database codes were analysed to infer the reason for prescription.


RESULTS
The proportion of new users of each product in 2002 and 2010, respectively, were: LNG/EE, 2.03% and 2.40%; CPA/EE, 0.45% and 0.27%; and DRSP/EE, 0.27% and 0.56%. Most new users prescribed CPA/EE had a record of acne (51.0% and 79.2% in 2002 and 2010, respectively) or hirsutism (3.0% and 5.0% in 2002 and 2010, respectively); the proportion of new users with a record only for contraception decreased from 32.9% in 2002 to 8.6% in 2010. Among new users prescribed DRSP/EE or LNG/EE in 2010, 43.2% and 30.8% of women, respectively, did not have a record indicating use for contraception.


CONCLUSIONS
Adherence to prescribing guidelines for CPA/EE has improved over time. A substantial proportion of women using DRSP/EE or LNG/EE had records for hormone-responsive conditions only, suggesting that many women were prescribed these therapies for non-contraceptive use.
Pharmacoepidemiologist, Spanish Centre for Pharmacoepidemiologic Research (CEIFE), Madrid, Spain.|Department of Preventive Medicine and Public Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.
Lucía
L
Cea-Soriano
Professor, Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden.
Mari-Ann
MA
Wallander
Pharmacoepidemiologist, Spanish Centre for Pharmacoepidemiologic Research (CEIFE), Madrid, Spain.
Luis Alberto
LA
García Rodríguez
cyproterone acetate; drospirenone; hormonal contraception; levonorgestrel; pharmacoepidemiology; prescribing