The relationship between area deprivation and prescription of long-acting reversible contraception in women of reproductive age in Lothian, Scotland, UK
The relationship between area deprivation and prescription of long-acting reversible contraception in women of reproductive age in Lothian, Scotland, UK
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DOI：
10.1136/jfprhc-2016-101553
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发表时间：
2017-10-01
影响因子：
--
通讯作者：
Liu, Hanhua
中科院分区：
文献类型：
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作者：
Morgan, Catherine Rachel;Liu, Hanhua
在苏格兰，减少计划外怀孕是政府的一个关键目标。长效可逆避孕（LARC）是减少意外怀孕的一种具有成本效益的方法。堕胎和少女怀孕率在最贫困地区最高。一个可能的解释是避孕处方的不平等。本研究探讨了区域剥夺测量的苏格兰指数的多次dependence和LARC prescription.Methods使用苏格兰电子处方数据从初级保健和性与生殖健康诊所，本研究分析了女性洛锡安居民的有效邮政编码年龄在16-49岁谁收到避孕药处方从2012年4月1日至2014年3月31日之间的关系。LARC（宫内避孕药、埋植避孕药或注射避孕药）与非LARC（口服避孕药、贴剂、避孕环或避孕膜）的处方进行了比较。结果共纳入90150例妇女，LARC处方占21.1%，vLARC（宫内方法或植入）占15.3%。居住在最贫困的五分之一人口（Q1）中并接受处方避孕的妇女获得LARC的比例明显高于五分之二至五分之一人口（Q2-5）。与Q1相比的比值比为：Q2 0.86，Q3 0.77，Q4 0.59和Q5 0.51。第1组妇女接受vLARC的可能性也显著高于第2- 5组妇女。结论洛锡安最贫困的五分之一妇女接受LARC和vLARC的可能性显著高于贫困程度较低的五分之一妇女。
Background Reducing unplanned pregnancy in Scotland is a key government objective. Long-acting reversible contraception (LARC) is a cost-effective way to reduce unintended pregnancy. Abortion and teenage pregnancy rates are highest in the most deprived areas. One possible explanation could be contraceptive prescribing inequality. This study examined the relationship between area deprivation measured by the Scottish Index of Multiple Deprivation and LARC prescription.Methods Using Scottish electronic prescribing data from primary care and sexual and reproductive health clinics, this study analysed female Lothian residents with a valid postcode aged 16-49 years who received a contraceptive prescription from 1 April 2012 to 31 March 2014. Prescription of LARC (intrauterine, implant or injectable contraceptive) compared with non-LARC (oral pill, patch, ring or diaphragm) was examined. Logistic regression was performed adjusting for age group and prescription location.Results A total of 90 150 women were included; 21.1% of prescriptions were LARC and 15.3% vLARC (intrauterine method or implant). Women residing in the most deprived quintile (Q1) and prescribed contraception received a significantly higher proportion of LARC than quintiles 2-5 (Q2-5). Odds ratios compared with Q1 were: Q2 0.86, Q3 0.77, Q4 0.59 and Q5 0.51. Women in quintile 1 were also significantly more likely to receive vLARC than quintiles 2-5.Conclusion Women in the most deprived quintile in Lothian who are prescribed contraception are significantly more likely to receive LARC and vLARC compared with women in less deprived quintiles.