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VTE in women may suggest inappropriate prescriptions of combined hormonal contraceptives
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Women assigned combined hormonal contraceptives who experience a venous thromboembolism may have vascular contraindications suggesting inappropriate prescriptions, according to findings published in the Journal of the Endocrine Society.
Genevievé Plu-Bureau, MD, PhD, of the department of gynecology and endocrinology, Hôpital Port-Royal in Paris, and colleagues evaluated 2,088 French women using combined hormonal contraceptives with a first confirmed episode of VTE referred to the hospital’s outpatient clinic between 2000 and 2009. Researchers sought to determine the prevalence of combined hormonal contraceptives prescribed counter to several international guidelines and the impact of such prescriptions on VTE.
Overall, 8.8% of participants with vascular contraindications to combined hormonal contraceptive use according to international guidelines received a prescription. According to the Royal College of Obstetricians and Gynaecologists recommendations, 18.9% of participants could be classified as combined hormonal contraceptive users with inappropriate prescriptions due to vascular contraindications and/or a family history of VTE; 25.9% were classified as inappropriate users according to the French National Authority for Health guideline. A family history of VTE was present in 11.2% of participants according to Royal College of Obstetricians and Gynaecologists recommendations, and 18.8% of participants according to the French National Authority for Health guideline. According to the different guidelines, preventable VTE events ranged from 6.3% to 18.5%.
“Between 8.8% and 25.9% of women with a VTE event associated with [combined hormonal contraception] use had an inappropriate prescription of [combined hormonal contraception],” the researchers wrote. “Between 6.3% and 18.5% of these VTE events could have been preventable. Our results suggest that prescribers should be made more aware of the recommendations to reduce inappropriate prescription without increasing the number of unwanted pregnancies, since other contraceptives strategies are available for these women. However, the appropriate way to take into account for family history of VTE should be further clarified.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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