Obstetrics & Gynecology

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Obstetrics & Gynecology:
doi: 10.1097/AOG.0000000000000279
Contents: Original Research

Receipt of Prescription Contraception by Commercially Insured Women With Chronic Medical Conditions

DeNoble, Anna E. MSc; Hall, Kelli S. PhD, MS; Xu, Xiao PhD; Zochowski, Melissa K. BS, MBA; Piehl, Kenneth BS; Dalton, Vanessa K. MD, MPH

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Abstract

OBJECTIVE: To assess differences in receipt of prescription contraception among women with and without chronic medical conditions.

METHODS: This observational study used 3 years of administrative claims records for insured women aged 21–45 years who were enrolled in a commercial insurance company in Michigan between 2004 and 2009. Women were considered to have a chronic medical condition if they had at least two claims for one of the following conditions, in order of prevalence in our study population: hypertension, asthma, hypothyroidism, diabetes, obesity, rheumatoid arthritis, inflammatory bowel disease, or systemic lupus erythematosus. Our primary outcome was receipt of prescription contraception, defined by a pharmacy claim or diagnostic or procedural code. We used multivariable logistic regression to estimate the association of chronic condition status with the odds of receiving prescription contraception within 3 years adjusting for age, community-level socioeconomic status, total outpatient visits, and cervical cancer screening.

RESULTS: Of 11,649 women studied, 16.0% (n=1,862) had at least one of the chronic conditions we considered. Of those with a chronic condition, 33.5% (n=623) received prescription contraception during the 3-year study period compared with 41.1% (n=4,018) of those without a chronic condition (P<.001). After adjusting for covariates, women with a chronic condition remained less likely than women without a chronic condition to have received prescription contraception (adjusted odds ratio 0.85, 95% confidence interval 0.76–0.96, P=.010).

CONCLUSION: Despite a greater risk for adverse outcomes with an unplanned pregnancy, women with these chronic conditions were less likely to receive prescription contraception.

LEVEL OF EVIDENCE: III

© 2014 by The American College of Obstetricians and Gynecologists.

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