Bingham Amie L, Garrett Cameryn C, Bayly Christine, Kavanagh Anne M, Keogh Louise A, Bentley Rebecca J, Hocking Jane S
Centre for Health Equity, Melbourne School of Population & Global Health, University of Melbourne, 207 Bouverie Street, Carlton, 3010, Australia.
The Royal Women's Hospital, 20 Flemington Road, Parkville, Melbourne, VIC, Australia.
BMC Womens Health. 2018 Nov 27;18(1):194. doi: 10.1186/s12905-018-0680-3.
Unplanned pregnancy is a significant problem in Australia. Local data pertaining to use of the levonorgestrel-releasing intra-uterine device (LNG-IUD), and associated factors are limited. The aim of this analysis was to calculate prescribing rates of the LNG-IUD in Australia, including trends in prescribing and associations with socio-demographic factors, in order to increase understanding regarding potential use.
We examined prescriptions for the LNG-IUD recorded in the national Pharmaceutical Benefits Scheme (PBS) from 2008 to 2012. Prescribing trends were examined according to patient age, remoteness of residential location, and proximity to relevant specialist health services. Associations between these factors and prescription rates were examined using poisson regression. Analyses were stratified by 5-year age-groups.
Age-adjusted prescription rates rose from 11.50 per 1000 women aged 15-49 (95% CI: 11.41-11.59) in 2008 to 15.95 (95% CI:15.85-16.01) in 2012. Prescription rates increased most among 15-19-year-olds but remain very low at 2.76 per 1000 women (95% CI: 2.52-3.01). Absolute increases in prescriptions were greatest among 40-44-year-olds, rising from 16.73 per 1000 women in 2008 (95% CI: 16.12-17.34) to 23.77 in 2012 (95% CI: 22.58-24.29). Rates increased significantly within all geographical locations (p < 0.01). Non-metropolitan location was significantly associated with increased prescribing rates, the association diminishing with increasing age groups.
Prescription of LNG-IUD in Australia is very low, especially among young women and those in major cities. Service providers and young women may benefit from targeted education outlining use of the LNG-IUD, strengthened training and referral pathways. Disparities in prescription according to location require further investigation.
意外怀孕在澳大利亚是一个重大问题。关于左炔诺孕酮宫内节育器（LNG-IUD）使用情况及相关因素的本地数据有限。本分析的目的是计算澳大利亚LNG-IUD的处方率，包括处方趋势以及与社会人口学因素的关联，以增进对其潜在用途的了解。
我们研究了2008年至2012年国家药品福利计划（PBS）中记录的LNG-IUD处方。根据患者年龄、居住地点的偏远程度以及与相关专科医疗服务的距离来研究处方趋势。使用泊松回归分析这些因素与处方率之间的关联。分析按5岁年龄组进行分层。
年龄调整后的处方率从2008年每1000名15至49岁女性中的11.50（95%可信区间：11.41 - 11.59）上升至2012年的15.95（95%可信区间：15.85 - 16.01）。15至19岁女性的处方率增长最为显著，但仍非常低，为每1000名女性2.76（95%可信区间：2.52 - 3.01）。处方绝对增加量在40至44岁女性中最大，从2008年每1000名女性中的16.73（95%可信区间：16.12 - 17.34）增至2012年的23.77（95%可信区间：22.58 - 24.29）。所有地理位置的处方率均显著上升（p < 0.01）。非大城市地区与处方率增加显著相关，且这种关联随着年龄组的增加而减弱。
澳大利亚LNG-IUD的处方率非常低，尤其是在年轻女性和大城市女性中。服务提供者和年轻女性可能会从关于LNG-IUD使用的针对性教育、强化培训和转诊途径中受益。根据地点的处方差异需要进一步调查。
