Prescriptive contraceptive use among isotretinoin users in the Netherlands in comparison with non-users: a drug utilisation study

• Published in: Pharmacoepidemiology and drug safety 2012-10, Vol.21 (10), p.1060-1066
• Main Authors: Crijns, Hubertina J.M.J., van Rein, Nienke, Gispen-de Wied, Christine C., Straus, Sabine M., de Jong-van den Berg, Lolkje T.W.
• Format: Article
• Language: English
• Subjects: Abnormalities, Drug-Induced - prevention & control; Adolescent; Adult; Age Distribution; Birth control; Compliance; contraception; Contraceptive Agents; Contraindications; Dermatologic Agents; Female; Humans; Isotretinoin; Male; Middle Aged; Netherlands; PPP adherence; Prescriptions; Prescriptions - statistics & numerical data
• ISSN: 1053-8569; 1099-1557
• DOI: 10.1002/pds.3200

ABSTRACT Purpose To assess the compliance with the isotretinoin Pregnancy Prevention Programme (PPP) by evaluating the use of prescribed contraceptives among isotretinoin users. The PPP contains a requirement for the use of contraceptive methods for women of childbearing potential. Methods A drug utilisation study was performed using data from a drug prescription database (containing Dutch community pharmacy data) covering a population of 500 000 patients. Contraceptive use in female isotretinoin users and in a reference group of female non‐isotretinoin users (aged 15–49 years) was compared using data from 1999 until 2006 in 2‐year periods. Descriptive statistics were used. Results Of the female isotretinoin users (n = 651), 52%–54% filled prescriptions on contraceptives in strict accordance to the PPP, used before, during, and after discontinuation of isotretinoin, compared with 39%–46% in the reference group. A more liberal approach of a minimum of one prescription for a contraceptive method showed 61%–64% use of contraceptives among isotretinoin users. Similar patterns were seen when data were broken down in age groups. Furthermore, a higher proportion of female patients using isotretinoin prescribed by general practitioners used prescribed contraceptives compared with those receiving isotretinoin by specialists. Conclusion Compliance with the contraceptive use according to a PPP for a teratogenic drug such as isotretinoin is 52%–64%, which is lower than anticipated. Reasons for the low compliance will need to be clarified before further measures can be taken. Copyright © 2012 John Wiley & Sons, Ltd.