Journal
AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY
Volume 61, Issue 1, Pages 128-134Publisher
WILEY
DOI: 10.1111/ajo.13257
Keywords
contraception; drug utilisation; hormonal contraception; long-acting reversible contraception
Categories
Funding
- Robinson Research Institute Career Development Fellowship from the University of Adelaide
- Lloyd Cox Research Fellowship from the University of Adelaide
- Mid-Career Fellowship from The Hospital Research Foundation
- Dementia Australia
- Yulgilbar Foundation innovation
- Robinson Research Institute
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The rate of hormonal LARC use among reproductive-aged women in Australia has doubled over the past decade, with variations in usage observed according to age groups and state/territory.
Background: Long-acting reversible contraceptives (LARCs) are promoted internationally as a key strategy for reducing unintended pregnancy and abortion rates. Aims: To examine trends in use of hormonal LARCs among reproductive-aged women in Australia between 2006 and 2018 and explore trends according to age groups and state/territory of dispensing. Materials and Methods: Retrospective population-based study using Pharmaceutical Benefits Scheme (PBS) dispensing claims of a 10% random sample of females aged 15-44. We investigated rates and annual trends in dispensing claims of etonorgestrel implant and levonorgestrel intrauterine systems (IUS). Results: Between 2006 and 2018, annual PBS claims for LARCs increased approximately two-fold from 21.7 to 41.5 per 1000 women, with a plateau observed from 2015 onward. Absolute rate increases were similar for the implant (9.0/1000) and IUS (10.8/1000), with increases observed across all age groups and states/territories. Overall dispensing rates varied by two-fold according to state/territory of dispensing and four-fold according to age groups. Rate increases for the implant were highest among the 15-19 and 20-24 age groups, while rate increases for the IUS were highest among the 35-39 and 40-44 age groups. It is estimated that in 2018, 10.8% of women aged 15-44 were using a LARC; 4.5% for the implant and 6.3% for the IUS. Conclusions: Rates of hormonal LARC use have doubled over the past decade. Investigating underlying reasons for the large observed differences in rates of use according to age and state/territory could help further improve uptake for these most effective methods of contraception.
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