Provision of contraceptive prescriptions following medication abortion in Australian general practice: A National Longitudinal Study using MedicineInsight, 2013-2022.

OBJECTIVES

To assess longitudinal trends in contraceptive prescribing following medication abortion (MA) in general practice.

STUDY

DESIGN

Retrospective cohort study of patients aged 14-49 years who were provided MA in the Australian general practice setting between 2013 and 2022. Data, including prescribed medications, were sourced from the national general practice dataset, MedicineInsight. The primary outcome was the proportion prescribed a contraceptive within 60 days of MA.

RESULTS

Among 4543 undergoing MA, 1841 (40.5%) received a contraceptive prescription within 60 days, with a modest increase over time from 32.0% in 2013-41.3% in 2022. Among those prescribed contraceptives, the most common types were the combined oral contraceptive pill (34.0%), levonorgestrel intrauterine device (27.0%), implant (24.6%) and injection (11.2%), with 931 (50.6%) of prescriptions provided on the same day as MA. The likelihood of receiving a contraceptive prescription was higher among those aged 14-19 years (RR 1.40; 1.21-1.62) and 20-24 years (RR 1.20; 1.08-1.34) compared with the 30-34-year-old group, and in those who were existing patients than new to the practice at time of MA provision (RR 1.15; 1.02-1.31). A positive linear relationship was observed between increasing socioeconomic status and increasing remoteness and higher rates of contraceptive prescription (both p < 0.001).

CONCLUSIONS

Less than half of patients undergoing MA in the general practice setting are provided a contraceptive prescription within 60 days of MA, most commonly the combined oral contraceptive pill. A most increase in contraceptive provision is evident over time, with provision varying significantly according to contraceptive type and patient characteristics.

IMPLICATIONS: Further research is required to understand underlying reasons for observed variation in contraceptive provision following MA in the general practice setting to ensure all individuals are being provided access to appropriate contraceptive information and services as part of high-quality abortion care.