Effect of the Covid pandemic on progestogen-only and oestrogen-containing contraceptive prescribing in general practice: a retrospective analysis of English prescribing data

Abstract

Objectives

This paper looks at how trends in contraceptive prescribing by General Practices in England were affected by the Covid pandemic and lockdown. It compares English prescribing data from May 2014 to May 2021, including the period of ‘lockdown’, from April 20-June 20.

Design & Setting

A retrospective analysis of the English Prescribing Dataset which reports monthly on prescribed items from English General Practices was carried out. Data on all forms of prescribed contraceptive methods were extracted using British National Formulary (BNF) codes, and total quantities tabulated by method, then transformed into ‘months of contraception provided’ by each method.

Results

Prescription of the combined oral contraceptive pill reduced by 22% during the period of lockdown compared to the same three months in 2019. Prescriptions of Progestogen-Only pills remained stable. This continued a trend in oral contraceptive prescribing evident from May14. Prescription of long-acting methods reduced during the period of lockdown, with the greatest reductions in implants (76% reduction from pre-lockdown levels), intra-uterine systems (79% reduction from pre-lockdown levels) and intrauterine devices (76% reduction from pre-lockdown levels). These rates of contraceptive provision recovered quickly after the period of lockdown ended.

Conclusions

The disruption of face-to-face contraceptive consultations in General Practice during a Covid-19 ‘lockdown’ has resulted in a reduction in oestrogen –containing methods compared to progestogen-only methods, which require less face-to-face monitoring. Implant and intrauterine contraceptive device prescription reduced by three quarters over the first three months of lockdown, but rebounded in the next year.

摘要

目的：本文探讨了新冠肺炎大流行和封控对英国常规避孕处方应用趋势的影响。本研究对2014年5月至2021年 5月间的英国处方数据进行比较, 包括4月20日至6月20日的“封锁期”。

设计与设置：对英国处方数据集进行回顾性分析, 该数据集每月报告来英国全科临床实践的处方情况。应用英国国家处方集（BNF）代码提取所有形式处方避孕手段的数据, 并按避孕方法列出处方总数目, 然后转换为“每月份不同避孕方法”提供的情况。

结果：与2019年同期三个月相比, 封锁期间复方口服避孕药处方减少22%。单纯孕激素药处方保持稳定。这延续了5月14日以来口服避孕药处方的趋势。在封锁期间, 长效避孕处方减少, 植入物（比封锁前水平降低76%）、宫内避孕系统（比封锁后水平降低79%）和宫内节育器（比封锁之前水平降低76%）的降低幅度最高。封锁期结束后, 这些避孕处方应用率迅速恢复。

结论：在Covid-19“封锁”期间, 由于常规面对面避孕咨询的中断, 相比单纯孕激素处方, 含雌激素处方的应用减少。在封锁的前三个月, 植入物和宫内节育器的处方减少了四分之三, 但在第二年有所反弹。

缩写：CHC：复方激素避孕；PO：单纯孕激素；COC：复方口服避孕药；POP：单纯孕激素药；长效可逆避孕方法；IUC：宫内避孕；IUD：宫内节育器（铜）；IUS：宫内避孕系统（单纯孕激素）

Keywords:

• Prescriptions
• general practice
• contraception
• Covid-19
• England

Disclosure statement

Susan Walker has previously received grant funding from Bayer PLC and has been a consultant for NaturalCycles, a company manufacturing a contraceptive app.

Data availability statement

Data used in this analysis is publicly available. https://www.nhsbsa.nhs.uk/prescription-data/prescribing-data/english-prescribing-data-epd