Co-cyprindiol prescribing in a large, rural general practice in England

To describe current co-cyprindiol prescribing in a large, rural general practice in England. To specifically investigate whether co-cyprindiol is prescribed within its license and Medicines and Healthcare products Regulatory Agency (MHRA) guidelines. To investigate the effect of a simple, low-cost intervention on the number and appropriateness of co-cyprindiol prescriptions.

The computerised medical record system in a 17,435 patient general practice was examined to identify individuals prescribed co-cyprindiol. The medical records for each individual identified were examined to see if they satisfied the MHRA guidelines in co-cyprindiol use. Prescribers were then contacted and sent copies of the MHRA guideline. All patients were invited to attend for review. Prescriptions for co-cyprindiol were then re-audited.

Co-cyprindiol comprised 3.4% of total combined oral contraceptive prescriptions. The most common indication was acne (69%). At baseline, the majority of prescriptions did not meet the MHRA guidelines. Prescriptions that did not meet guidelines tended to have been for longer (32 vs 19.5 months). After the intervention, the number of individuals prescribed co-cyprindiol fell (26 vs 12) and the number of prescriptions that met the guidelines increased (30.7% vs 75%). The largest change was a decrease in inappropriate prescriptions for acne.

In this population, co-cyprindiol was rarely prescribed, though its use often contravened guidelines. Simple interventions can increase appropriateness of prescribing.