Leading towards Health for All
Creating Synergies between Public Health and Primary Care
Keywords: Contraception, hormone replacement therapy
Introduction:
GPs are the main prescribers of contraception and hormone replacement therapy in Ireland. The WHO advocates for high quality, affordable sexual and reproductive health services. Information should be provided about the full range of family planning methods (1). Similarly, as women enter their post reproductive years they should have access to information on how to optimise their menopause transition.
This study demonstrates the changing trends in prescribing practices in Ireland over a 12.5 year period using data provided by the Health Service Executive Primary Care Reimbursement Services (HSE‐PCRS) through the General Medical Service (GMS) scheme. As of December 2022, the GMS scheme provides 31% of the Irish population with free, or heavily subsided, medical care (2)(3).
Since 2016, GPs have been claiming additional reimbursement to resource fitting/removal of long-acting reversible contraceptive devices (LARCs) for patients with GMS (and Doctor-Visit Only) cards.
Method:
Anonymised and aggregated data were obtained from the HSE-PCRS describing hormonal contraception and HRT dispensing records from 2010 to June 2022. Data for GPs claims for removing/inserting LARC devices were available from 2016 to June 2022.
Results:
A total of 11.8m contraceptive and HRT medications were dispensed to patients with GMS entitlement over the study period (with projected figures used for 2022 based on items dispensed and LARC claims for the first six months of the year). Of these 10.1m were short acting contraceptives, 319k were LARC items, 303k were emergency contraceptive items, and 28k were rarer items used for other indications.
Finally, 1.1m were HRT preparations.
Use of short acting methods of contraception is reducing while use of safer progesterone only pills is increasing.
Use of LARC is stable, despite a reduction in insertions during the covid pandemic. HRT prescribing has increased (prescriptions almost trebled between 2018 and 2022).
Conclusions:
This study provides valuable information on prescribing trends.
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