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dc.contributor.authorSæbø, Sunniva
dc.contributor.authorSkjeldestad, Finn Egil
dc.date.accessioned2024-11-07T09:31:51Z
dc.date.available2024-11-07T09:31:51Z
dc.date.issued2024-06-27
dc.description.abstractIntroduction: The Norwegian Government introduced in 2002 a reimbursement scheme for hormonal contraceptives to adolescents at the same time as public health nurses and midwives received authorization to prescribe hormonal contraceptives. This study examines the impact of increased accessibility and public funding on hormonal contraceptive use among adolescents.<p> <p>Material and Methods: The Norwegian Prescription Database, Statistics Norway, and Norwegian Institute of Public Health served as data sources for this cohort study. The study population comprised 174 653 Norwegian women born 1989–1990, 1994– 1995, and 1999–2000. We examined use of hormonal contraceptives through dis pensed prescriptions from age 12 through age 19 with duration of first continuous use as primary outcome. The statistical analyses were done in SPSS using chi-squared test, survival analysis, and Joinpoint regression analysis with p-values < 0.05. <p>Results: By age 19, ~75% of the cohorts had used at least one hormonal method. The main providers of the first prescription were general practitioners and public health nurses. Starters of progestogen-only pills (POPs) have increased across the cohorts, while starters of combined oral contraceptives (COCs) have decreased. The use of long-acting reversible contraceptives (LARCs) has increased since its inclusion in the reimbursement scheme (2015). Most switchers shifted from COCs or POPs as a start method to implants after LARCs became part of the reimbursement scheme. There has been a significant increase across the cohorts in the number of women who continuously used hormonal contraceptives from start to the end of the calendar year they became 19 years with the same method and after switching methods. We could not correlate changes in decreasing trends for teenage births or induced abortions (Joinpoint analysis) to time for implementation or changes in the reimbursement of hormonal contraceptives from 2002. <p>Conclusions: Primarily public health nurses and to a lesser extent midwives became soon after they received authorization to prescribe COCs important providers. The expansion of the reimbursement scheme to cover POPs, patches, vaginal ring, and depot medroxyprogesterone acetate in 2006 had minor impact on increasing the proportion of long-term first-time users. However, the inclusion of LARCs in 2015 significantly increased the proportion of long-term first-time hormonal contraceptive users.en_US
dc.identifier.citationSæbø, Skjeldestad. How have changes in accessibility and public funding influenced contraceptive use among Norwegian adolescents? A cohort study. Acta Obstetricia et Gynecologica Scandinavica. 2024;103(9):1789-1798en_US
dc.identifier.cristinIDFRIDAID 2294650
dc.identifier.doi10.1111/aogs.14905
dc.identifier.issn0001-6349
dc.identifier.issn1600-0412
dc.identifier.urihttps://hdl.handle.net/10037/35509
dc.language.isoengen_US
dc.publisherWileyen_US
dc.relation.journalActa Obstetricia et Gynecologica Scandinavica
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2024 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0en_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)en_US
dc.titleHow have changes in accessibility and public funding influenced contraceptive use among Norwegian adolescents? A cohort studyen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Med mindre det står noe annet, er denne innførselens lisens beskrevet som Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)