Trends in prescribing patterns of hormonal contraceptives for adolescents

O'Brien, Sarah H.; Kaizar, Eloise E.; Gold, Melanie A.; Kelleher, Kelly J.

doi:10.1016/j.contraception.2007.12.009

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Volume 77, Issue 4 , Pages 264-269, April 2008

Trends in prescribing patterns of hormonal contraceptives for adolescents

Sarah H. O'Brien
- Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA
- Division of Hematology/Oncology, Nationwide Children’s Hospital/Ohio State University, Columbus, OH 43205, USA
- Corresponding author. The Research Institute at Nationwide Children's Hospital, J1415 Columbus, OH 43205, USA. Tel.: +1 614 722 3183; fax: +1 614 722 3544.
Eloise E. Kaizar
- Department of Statistics, Ohio State University, Columbus, OH 43210, USA
Melanie A. Gold
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
Kelly J. Kelleher
- Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA

Received 20 October 2007; received in revised form 20 November 2007; accepted 15 December 2007. published online 20 February 2008.

Abstract

Background

Little is known regarding how prescribing patterns of hormonal contraceptives to adolescents in the United States have changed over time as new formulations become available and knowledge of thrombosis risk increases. Desogestrel and high-dose estrogen-containing formulations have been associated with a higher risk of thrombosis than other methods.

Study design

We used the National Ambulatory Medical Care/National Hospital Ambulatory Medical Care surveys to describe trends in contraception prescriptions for 11- to 21-year-old females between 1993 and 2004.

Results

The majority of prescriptions arose from obstetrics/gynecology clinics. The proportion of desogestrel-containing prescriptions was ∼10% throughout the study period. Ortho Evra (transdermal norelgestromin, ethinyl estradiol) and Yasmin (oral drospirenone, ethinyl estradiol) accounted for a steadily increasing proportion of prescriptions.

Conclusion

With regard to contraception and thrombosis risk, a significant minority of adolescents are prescribed desogestrel-containing contraceptives, and a greater number are exposed to higher levels of estrogen from transdermal contraception. Future studies are needed to evaluate the absolute risk of thrombosis in adolescents using these formulations so clinicians have accurate safety information when prescribing to this unique population.

Keywords: Contraception, Adolescence, Deep venous thrombosis (DVT)