Biomaterial Database

Recent oral contraceptive use patterns in four European countries: evidence for selective prescribing of oral contraceptives containing third-generation progestogens. 1996

H W van Lunsen

Department of Sexology and Psychosomatic Gynecology, University of Amsterdam, The Netherlands.

A survey among oral contraceptive (OC) prescribers in the United Kingdom, Germany, Sweden and the Netherlands was performed to investigate OC prescription patterns before and after recent publicity in the media about studies reporting a higher risk of venous thromboembolism with OCs containing third-generation progestogens as compared to OCs containing second-generation progestogens. Before this publicity, most physicians prescribed third-generation OCs as their first-choice formulations for normal healthy women as well as for young girls (< 20 years) and older fertile women (30-35 years). In women presenting with cardiovascular risk factors, third-generation progestogens (desogestrel, gestodene) were considered safer and were five times more often prescribed than second-generation preparations (71% versus 14%). Most prescribers considered ethinylestradiol to be the most important component in relation to the risk of venous thromboembolism (71%), myocardial infarction (66%) and stroke (67%). In addition, for women presenting with cardiovascular risk factors, OC preparations containing 20 or 30 micrograms ethinylestradiol were considered safer than preparations containing 35 or 50 micrograms ethinylestradiol. Although the vast majority of prescribers (78%) stated that their attitudes towards safety of third-generation OCs had not changed since the recent publicity and the regulatory actions in some countries, 56% had changed their prescribing practice, largely due to patient concern about the safety of third-generation OCs. The results from this survey strongly suggest that, prior to the recent publicity, most prescribers considered third-generation OCs to be safer than second-generation preparations. Because of this perceived better safety profile, physicians have selectively been prescribing third-generation OCs to women at increased risk of cardiovascular disease. This pattern of selective OC prescribing may have seriously biased the results of the recently published studies on OCs and venous thromboembolism in favor of second-generation OCs.

UI	MeSH Term	Description	Entries
D007722	Health Knowledge, Attitudes, Practice	Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).	Knowledge, Attitudes, Practice
D008402	Mass Media	Instruments or technological means of communication that reach large numbers of people with a common message: press, radio, television, etc.	Broadcast Media,Folk Media,Printed Media,Media, Broadcast,Media, Folk,Media, Mass,Media, Printed
D009426	Netherlands	Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, and Sint Maarten, formerly included in the NETHERLANDS ANTILLES.	Holland,Kingdom of the Netherlands
D010818	Practice Patterns, Physicians'	Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.	Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D010820	Physicians	Individuals licensed to practice medicine.	Physician
D011307	Drug Prescriptions	Directions written for the obtaining and use of DRUGS.	Drug Prescribing,Drug Prescription,Drug Prescribings,Prescribing, Drug,Prescribings, Drug
D011795	Surveys and Questionnaires	Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions.	Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D002626	Chemistry, Pharmaceutical	Chemistry dealing with the composition and preparation of agents having PHARMACOLOGIC ACTIONS or diagnostic use.	Medicinal Chemistry,Chemistry, Pharmaceutic,Pharmaceutic Chemistry,Pharmaceutical Chemistry,Chemistry, Medicinal
D003277	Contraceptives, Oral, Combined	Fixed drug combinations administered orally for contraceptive purposes.	Combined Oral Contraceptive,Contraceptive Agents, Female, Combined,Oral Contraceptives, Combined,Combined Oral Contraceptives,Contraceptive, Combined Oral,Contraceptives, Combined Oral,Oral Contraceptive, Combined
D004363	Drug Utilization	The utilization of drugs as reported in individual hospital studies, FDA studies, marketing, or consumption, etc. This includes drug stockpiling, and patient drug profiles.	Utilization, Drug,Drug Utilizations,Utilizations, Drug