gms | German Medical Science

Background: In 1961 the first combined oral contraceptive (COC) was introduced in West Germany. Since that time more and more synthetic hormones were developed and the number of contraceptive preparations strongly increased. Nowadays, there are four generations of gestagens. Their contraceptive effect is equal but they differ in their desired and undesired side-effects, especially in the thromboembolic risk. For some gestagens of the third and fourth generation, e.g. drospirenone the higher thromboembolic risk is proven, for others, e.g. dienogest it is discussed. Thus, in 2014 the German Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM) decided to add special warnings to the summary of product characteristics of combined oral contraceptives of the third and fourth generation highlighting their thromboembolic risk.

Due to advertisement und marketing sponsored by the pharmaceutical industry it seems that oral contraceptives are more and more perceived as lifestyle products instead of highly effective drugs.

Therefore, the aim of this study was to evaluate the incidence and characteristics of prescriptions of oral contraceptives for young women in Germany. Further, we wanted to elucidate whether specific and target-group oriented information is able to improve patient-centered care with and safety of oral contraceptives.

Materials and Methods: Specific information for health care professionals was provided by the "Pillenreport", published by Techniker Krankenkasse (TK) in October 2015. In this report we evaluated the prescription frequency of oral contraceptives for young women at the age of 11-19 years insured by TK from 2011-2013. The data were analyzed for differences in age, region and generation of the gestagen. "Pillenreport" was also accompanied by a wide-ranging information campaign for young woman, including a website and TV performances in order to reveal whether targeted information is able to improve patient-centered care. Accordingly, the prescription data were analyzed again one year later.

Results: The prescription frequency of oral contraceptives increases with age. At the age of 19, 70% of the female insured by the TK took contraceptives. Two-third of these women received preparations of the third and fourth generation. Looking at all age groups, the data show that oral contraceptives of the third and fourth generation are more frequently prescribed than those of the second generation.

As a result of "Pillenreport" and the information campaign, many young women started informing themselves more about the benefit-risk-ratio of these preparations and perceiving oral contraceptives as highly effective drugs instead of lifestyle products.

Conclusion: Overall the present study suggests that targeted information is able to influence and improve patient-centered care with (combined) oral contraceptives despite massive advertisement by the pharmaceutical industry.