Regional differences in utilization of 17α-hydroxyprogesterone caproate (17-OHP)

Area of Science:

• Obstetrics and Gynecology
• Pharmacology
• Health Services Research

Background:

• 17α-hydroxyprogesterone caproate (17-OHP) is indicated for women with a history of spontaneous preterm birth.
• Understanding regional utilization patterns is crucial for improving access and adherence to evidence-based therapies.

Purpose of the Study:

• To investigate geographical disparities in the utilization of 17-OHP among singleton pregnancies with a history of spontaneous preterm birth.
• To assess the overall prescription rates of 17-OHP within a US commercial managed care population.

Main Methods:

• Retrospective analysis of a US commercial managed care claims database (2008-2018).
• Inclusion criteria: singleton pregnancies with at least one prior spontaneous preterm birth.
• Comparison of 17-OHP utilization rates across US regions and states using statistical tests.

Main Results:

• 12.8% (580/4,514) of eligible individuals received 17-OHP prescriptions.
• Significant regional differences in utilization were found: Northeast (15.7%), Midwest (13.7%), South (12.0%), and West (10.4%) (p=0.003).

Conclusions:

• Low overall utilization of 17-OHP persists, despite identified regional variations.
• A gap exists between clinical research findings and actual practice, highlighting the need for improved implementation science in obstetrics.
• Enhanced strategies are required to translate updated preterm birth prevention guidelines into clinical practice effectively.