The faculty of family planning and reproductive healthcare guidance on
12-month supply of the pill – is it happening?
H. Cockburn, L.A.
Green Family Planning and Well Woman Services, Edinburgh, Scotland, UK
Objective: To identify whether the UK Faculty of Family Planning and
Reproductive Healthcare (FFPRHC) guidance advising the provision of up to 12
months supply of oral hormonal contraception to women established on the pill,
is being followed by providers in a central family planning service in Scotland.
Design: For a one-week period, all case records of patients who were
attending for hormonal contraception were audited at the end of the clinic
session. Staff were not informed of the audit. The woman’s age, fertility
intentions, duration of pill use, use of the same brand of pill and duration of
supply of the pill that doctors prescribed for women were extracted from the
notes.
Results: 104 sets of case notes were reviewed. 26 women (25%) were
given twelve packets of pills. For these women the duration of use of current
brand of pill ranged from 9 months to 10 years. None of them was starting oral
contraception for the first time. 41 women (39%) received six packets of pills.
Four of these women (9.7%) had a medical problem including raised B.P, history
of migraine, or a problem with facial spots. 37 women (35%) received a
three-month supply. 67% of these women (25) were starting this pill for the
first time. For the others, the reasons for offering only 3 months supply
included smoking over 20 cigarettes daily, breakthrough bleeding, significant
weight gain. All women given only three months supply were invited for review
before they had used their full supply.
Conclusions: Despite the UK FFPRHC guidance, only 25% of women are
being supplied with 12 packets of oral contraception at routine follow-up. While
there appear to be good clinical reasons in most cases for providing only three
packets of pills, many women who are getting only six packets, could probably be
given enough to last for one year. The results will be fed back to the clinic
staff together with a reminder of the guidance and the audit will be repeated in
six months time.
