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Longitudinal trends in uptake of hormonal long-acting reversible contraception devices throughout the COVID-19 pandemic: an Australian population-based study
  1. Tahlee Blade Stevenson1,
  2. Alice R Rumbold2,3,
  3. Vivienne Moore1,2,
  4. Kelly Hall1,
  5. Jenni Ilomaki4,
  6. Danielle Mazza5,
  7. Deborah Bateson6,7,
  8. Luke E Grzeskowiak3,4,8
    1. 1School of Public Health, The University of Adelaide School of Public Health, Adelaide, South Australia, Australia
    2. 2Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
    3. 3Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
    4. 4Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Clayton, Victoria, Australia
    5. 5Department of General Practice, Monash University, Notting Hill, Victoria, Australia
    6. 6The Daffodil Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
    7. 7Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Science, The University of Sydney, Sydney, New South Wales, Australia
    8. 8College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
    1. Correspondence to Associate Professor Luke E Grzeskowiak, GPO Box 2100, Department of Clinical Pharmacology, Flinders University, Adelaide, SA 5001, Australia; luke.grzeskowiak{at}flinders.edu.au

    Abstract

    Background Little is known about the degree to which the COVID-19 pandemic, and associated restrictions and disruptions to health services, impacted the accessibility of hormonal long-acting reversible contraception (LARC) devices within Australia. Here, we explore longitudinal patterns of dispensing of the contraceptive implant and hormonal intrauterine devices (IUDs) within Australia, before and during the COVID-19 pandemic.

    Methods Population-based cohort study; analysis of 10% random sample of national Pharmaceutical Benefits Scheme dispensing data, for females aged 15–49 years dispensed a hormonal LARC device between February 2017 and November 2021.

    Results Interrupted time-series analysis demonstrated overall that there were no significant differences in monthly dispensing rates of hormonal LARC following the Australian onset of the pandemic in April 2020, with no subsequent change in the trend. However, when stratified by LARC type, a significant increase was evident during the pandemic period (April 2020–November 2021) in the rate of hormonal IUD dispensing per month (0.20 per 10 000 95% CI 0.01 to 0.38)), compared with a decrease for the implant (−0.08 per 10 000 (95% CI −0.16 to 0.01)). Increases in hormonal IUD dispensing during the pandemic were most pronounced for those aged 20–24 years, new users, those without a Commonwealth concession card, and in the State of Victoria.

    Conclusions Within Australia in the defined pandemic period, access to hormonal LARC devices was not negatively impacted. Rather a significant increase in dispensing of hormonal IUDs was evident.

    • intrauterine devices
    • Contraceptive Devices, Female
    • COVID-19
    • hormonal contraception
    • long-acting reversible contraception

    Data availability statement

    Data are available upon reasonable request. The study data cannot be publicly shared for reasons of ethics and privacy. Access to aggregate data, however, may be granted upon request to the corresponding author if deemed appropriate. All authors had full access to all study data (including statistical reports and tables).

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    Data availability statement

    Data are available upon reasonable request. The study data cannot be publicly shared for reasons of ethics and privacy. Access to aggregate data, however, may be granted upon request to the corresponding author if deemed appropriate. All authors had full access to all study data (including statistical reports and tables).

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    Footnotes

    • X @DrDebBateson

    • Contributors LEG designed and led the study with support from TBS and JI. LEG and KH were responsible for data analysis and the creation of figures. TBS drafted the first version of the article with support from VM and LEG. ARR, DM, and DB critically reviewed the first draft. All authors provided feedback on and revised the final content of the article. All authors gave final approval for the publication of the final version of the article. LEG is responsible for the overall content as guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests DB and DM have received honoraria, and research and travel funding from pharmaceutical companies marketing long-acting reversible contraception (LARC) products including Bayer and Organon.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.