Use of hormonal contraceptives by adolescents has increased over the past decade, a national retrospective cohort study has found.

Data were obtained from the IMS Disease Analyzer (IMS DA) database, on girls aged 12-18 years who had had at least one prescription for a contraceptive drug between 1 January 2002 and 31 December 2011. IMS DA contains anonymised information, including drug prescriptions, diagnoses and demographics, recorded by GPs in the UK.

Annual prevalence of contraceptive prescribing was calculated for two age bands: 12-15 years and 16-18 years.

A total of 44,532 girls aged 12-18 years were identified in 2002 from the database compared with 34,676 in 2011.

• The annual prevalence of contraceptive prescribing to those aged 12-15 years increased from 3.3% (95% CI:3.1-3.6%) in 2002 to 5.2% (95% CI:4.9-5.5%) in 2011.

• For the 16-18 age group, this rose from 25.7% (95% CI:25.0-26.3%) in 2002 to 34.6% (95% CI:33.7-35.5%) in 2011.

Contraceptive prescribing was consistently higher in the 16-18 years age group compared with the 12-15 age group from 2002 to 2011.

The most frequent indication for hormonal contraceptive prescriptions for both age groups was ‘contraceptive management’, followed by ‘excessive, frequent and irregular menstruation’.

The most common form of contraception for both groups of adolescents was the combined oral contraceptive pill; the formulation of ethinylestradiol/levonorgestrel accounted for more than 50% of all contraceptive prescriptions for both groups from 2002 to 2011.

Etonorgestrel implant use increased significantly for both groups: from 0.3% in 2002 to 9.4% in 2011 in the 12-15 age group; and from 0.4% in 2002 to 6.8% in 2011 in the 16-18 age group.

In the 12-15 age group use of the depot progestogen-only contraceptive increased from 4.7% in 2002 to 5.9%

in 2011 but in the 16-18 age group, the proportion dropped from 9.3% in 2002 to 8.4% in 2011.

The authors suggested that the general increase in prevalence of prescribing hormonal contraceptives by GPs to girls aged 12-18 might have partly explained the decrease in conception rate in those under 18 as contraception was the main indication for prescribing hormonal contraceptives.

In 1998, the UK had the highest teenage birth rate (30.8 per 1,000 in the 15-19 age group) in Western Europe. The Government’s ten-year national Teenage Pregnancy Strategy in 1999 was followed by a 34% reduction in the conception rate by 2011. However, despite this reduction, the UK ranking in Western Europe has not changed.

There is still a need to improve teenage access to contraception.

Dr Richard Ma

• Rashed AN, Hsia Y, Wilton L et al. Trends and patterns of hormonal contraceptive prescribing for adolescents in primary care in the UK. J Fam Plann Reprod Health Care doi:10.1136/jfprhc-2013-100724 online first