Effect of the British warning on contraceptive use in the General Medical Service in Ireland
Williams, D.; Kelly, A.; Carvalho, M.; Feely, J.
Irish Medical Journal 91(6): 202-203
1998
ISSN/ISBN: 0332-3102 PMID: 10069128 Document Number: 485163
In October 1995, the UK Committee on Safety of Medicines (CSM) issued a warning about the thromboembolic risk of third-generation oral contraceptives (OCs) and recommended a switch to second-generation formulations. The Irish Medical Board did not issue such a recommendation, but instead requested further study to assess the possible impact of bias and confounding. However, a review of OC prescribing data from before and after the CSM warning indicated that prescribers and pill users in Ireland were influenced more by the UK warning than by Irish regulatory agencies. All OCs prescriptions dispensed in Ireland's Eastern Health Board area (representing 40% of the General Medical Service) from January 1995 to November 1996 were examined. Prescriptions for third-generation OCs declined from 53% of total contraceptive steroid use in January 1995 to 30% in November 1996. This decline was paralleled by an increase of 12% (from 31% to 43%) in use of second-generation OCs and a 9% rise (from 9% to 18%) in distribution of norgestimate-containing OCs. These findings attest that decisions made in one country may have major consequences beyond geographic boundaries, even when the decision is contrary to another country's public health policy. Recommended, to ensure a more standardized approach to pharmacologic vigilance, is development of a European perspective on issues of drug safety.