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[Limited changes in prescription of third-generation oral contraceptives after reports on elevated thrombosis risk
P A Kersemakers1, A D Kester, T van der Weijden
1Universiteit Maastricht.
Objective:
To compare the prescription behaviour of general practitioners (GP) and gynaecologists regarding 2nd and 3rd generation oral contraceptives (OC) in the period before and after the warning of increased thrombosis risk of 3rd generation pills.
Design:
Retrospective, descriptive.
Method:
With the aid of data on OC prescriptions collected by the Institute for Medical Statistics, the numbers of prescriptions from Dutch GPs and gynaecologists in the year before the warning by the British Committee on Safety of Medicines that 3rd-generation OC increased the risk of thrombosis, were compared with the numbers in the year after publication of the guideline of the Dutch General Practitioners Society (NHG), which stated a preference for the 2nd-generation OC, and of the guideline of the Dutch Society for Gynaecology and Obstetrics, which stated no preference.
Results:
In neither the GP nor the gynaecologist groups did the proportion of 3rd-generation pills in the OC prescriptions decrease significantly. However, in the GP group the proportion of new 3rd generation OC prescriptions decreased significantly from 56 to 40%. However, after a few trimesters it rose again.
Conclusion:
The changes in prescription behaviour of the GP group were in accordance with the NHG guidelines. However, the proportion of the 3rd-generation OC prescriptions remained relatively large and the effect was of short duration. The only conclusion that could be drawn regarding the gynaecologists, was that the proportion of 3rd-generation OC prescriptions did not change significantly.