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Otto AK, Klein DA, Lau M, Dhar CP, Hwang LY. Over-the-counter access to hormonal contraception: a global perspective. Curr Opin Pediatr 2024; 36:382-388. [PMID: 38655795 DOI: 10.1097/mop.0000000000001346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
PURPOSE OF REVIEW Oral contraceptive pills are among the most popular contraceptives worldwide, including among adolescents, and are available over the counter in over 100 countries. However, when a prescription is required, oral contraceptives may be difficult to obtain, particularly for adolescents. Recent approvals of over-the-counter progestin-only pills in the United Kingdom and United States have brought widespread attention to this topic. RECENT FINDINGS Progestin-only pills, including the norgestrel pill recently approved for over-the-counter use in the United States, are highly effective and may be used safely without a prescription or medical monitoring, including by adolescents. These pills are associated with relatively high user satisfaction. Although over-the-counter availability may improve contraceptive access overall, issues related to insurance coverage and out-of-pocket cost may continue to pose practical barriers to access for many individuals. SUMMARY Over-the-counter oral contraceptives are an appropriate and important contraceptive option for many adolescents. Over-the-counter availability has the potential to increase access to safe and effective contraception in the United States, United Kingdom, and other countries where a prescription is currently required. Future research on use patterns among adolescents is needed, as are advocacy efforts and policies to ensure access and affordability.
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Affiliation(s)
- Alana K Otto
- Division of Adolescent Medicine, Department of Pediatrics, University of Michigan
| | - David A Klein
- Departments of Family Medicine and Pediatrics, Uniformed Services University, Bethesda, Maryland
- Department of Family Medicine, David Grant Medical Center, Travis Air Force Base, California
| | - May Lau
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Children's Medical Center Dallas
| | - Cherie P Dhar
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago
| | - Loris Y Hwang
- Department of Pediatrics, Division of Adolescent & Young Adult Medicine, University of California, Los Angeles, California, USA
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Reilly K, Schmuhl KK, Bonny AE. Removing Barriers to Contraceptive Access for Adolescents. J Pediatr Pharmacol Ther 2024; 29:331-335. [PMID: 38863847 PMCID: PMC11163908 DOI: 10.5863/1551-6776-29.3.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/04/2024] [Indexed: 06/13/2024]
Affiliation(s)
- Kristen Reilly
- Division of Adolescent Medicine (KR, KKS, AEB), Nationwide Children’s Hospital, Columbus, OH
| | - Kelsey K. Schmuhl
- Division of Adolescent Medicine (KR, KKS, AEB), Nationwide Children’s Hospital, Columbus, OH
- College of Pharmacy (KKS), The Ohio State University, Columbus, OH
| | - Andrea E. Bonny
- Division of Adolescent Medicine (KR, KKS, AEB), Nationwide Children’s Hospital, Columbus, OH
- Department of Pediatrics (AEB), College of Medicine, The Ohio State University, Columbus, OH
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Wilkinson TA, Meredith AH, Katz AJ, Meagher CG, Ott MA. Assessment of adolescent decision-making capacity for pharmacy access to hormonal contraception. Contraception 2023; 123:110002. [PMID: 36914146 PMCID: PMC10330126 DOI: 10.1016/j.contraception.2023.110002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES To examine adolescents' decision-making capacity for pharmacsist-prescribed hormonal contraception. STUDY DESIGN A subset of 60 females, ages 14-21, were recruited to complete the MacArthur Competence Assessment Tool-Treatment. Overall scores were compared by age and demographic factors and variation examined. RESULTS Participants scored high on the MacArthur Competence Assessment Tool-Treatment with little variation in the scores (18.8 [±1.9]/20 total points). Factors such as chronic illness, health literacy, and family affluence were not associated with of overall scores. CONCLUSIONS Adolescents and young adults have the capacity to make decisions regarding contraception in the pharmacy access settings.
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Affiliation(s)
- Tracey A Wilkinson
- Indiana University School of Medicine, Department of Pediatrics, Division of Children's Health Services Research, Indianapolis, IN, United States.
| | - Ashley H Meredith
- Department of Pharmacy Practice, Purdue College of Pharmacy, West Lafayette, IN, United States
| | - Amy J Katz
- Indiana University School of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Indianapolis, IN, United States
| | - Carolyn G Meagher
- Indiana University School of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Indianapolis, IN, United States
| | - Mary A Ott
- Indiana University School of Medicine, Department of Pediatrics, Division of Adolescent Medicine, Indianapolis, IN, United States
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Otto AK, Klein DA, Lau M, Santelli J, Dhar CP, Vyver E, Hwang LY. It's Time for Over-the-Counter Oral Contraceptive Pills. J Adolesc Health 2023; 72:829-830. [PMID: 37032214 DOI: 10.1016/j.jadohealth.2023.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/03/2023] [Accepted: 02/26/2023] [Indexed: 04/11/2023]
Affiliation(s)
- Alana K Otto
- Division of Adolescent Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan.
| | - David A Klein
- Departments of Family Medicine and Pediatrics, Uniformed Services University, Bethesda, Maryland; Department of Family Medicine, David Grant Medical Center, Travis Air Force Base, California
| | - May Lau
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - John Santelli
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York; Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York
| | - Cherie P Dhar
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Ellie Vyver
- Department of Pediatrics, Section of Adolescent Medicine, Alberta Children's Hospital, Calgary, Alberta, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Loris Y Hwang
- Division of Adolescent & Young Adult Medicine, Department of Pediatrics, University of California, Los Angeles, Los Angeles, California
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Vinciguerra M, Cascardi E, Lamanna B, Marrone M, Pititto F, Macorano E, Sciorio R, Baldini GM, Malvasi A, Ballini A, Cazzato G, Vimercati A, Kumaran S, Cicinelli E, Scacco S, Dellino M. A Multi-Institutional Informed Consent Proposal as a Prevention Tool for Combined Oral Contraceptive Intake and Thrombotic Risk. J Pers Med 2023; 13:jpm13040584. [PMID: 37108970 PMCID: PMC10144716 DOI: 10.3390/jpm13040584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Combined oral contraceptives (COC), are among the most widely used contraceptive methods in the world today. Despite the different changes in terms of estrogen/progestogen combinations and dosages, the thromboembolic risk for a woman who takes combined oral contraceptives persists to date. Methods: The review of relevant literature and international guidelines on prescription of combined oral contraceptives made it possible to create a proposal for informed consent to be used for prescribing. Results: The several sections of our consent proposal were designed according to a rationale in order to cover all the aspects presented by worldwide guidelines: how to take, adverse effects, advertisements, extra-contraceptive benefits and effects, a checklist for condition at risk of thromboembolism, the signature of the woman. Conclusions: An informed consent to standardize combined oral contraceptives prescription can improve women’s eligibility, mitigate thromboembolic risk, and assure legal protection to healthcare providers. In this systematic review in particular, we refer to the Italian medical–legal scenario, to which our group of researchers belongs. However, the model proposed was designed in the respect of main healthcare organization guidelines, and it could be easily used by any center in the world.
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Affiliation(s)
- Marina Vinciguerra
- Unit of Obstetrics and Gynaecology, Department of Biomedical Sciences and Human Oncology, 70132 Bari, Italy; (M.V.); (M.D.)
- Department of Obstetrics and Gynaecology, “Santa Caterina Novella Hospital”, 73013 Galatina, Italy
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy;
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, Str. Provinciale 142 km 3.95, 10060 Candiolo, Italy
| | - Bruno Lamanna
- Unit of Obstetrics and Gynaecology, Department of Biomedical Sciences and Human Oncology, 70132 Bari, Italy; (M.V.); (M.D.)
- Fetal Medicine Research Institute, King’s College Hospital, London SE5 9RS, UK
| | - Maricla Marrone
- Section of Legal Medicine, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Fortunato Pititto
- Section of Legal Medicine, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Enrica Macorano
- Section of Legal Medicine, Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Romualdo Sciorio
- EFREC (Edinburgh Assisted Conception Programme), “Royal Infirmary of Edinburgh”, Edinburgh EH16 4SA, UK
| | | | - Antonio Malvasi
- Unit of Obstetrics and Gynaecology, Department of Biomedical Sciences and Human Oncology, 70132 Bari, Italy; (M.V.); (M.D.)
| | - Andrea Ballini
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: (A.B.); (S.S.)
| | - Gerardo Cazzato
- Department of Precision and Regenerative Medicine and Jonic Area, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Antonella Vimercati
- Department of Precision and Regenerative Medicine and Jonic Area, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Senthil Kumaran
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Mangalagiri 522503, India
| | - Ettore Cicinelli
- Unit of Obstetrics and Gynaecology, Department of Biomedical Sciences and Human Oncology, 70132 Bari, Italy; (M.V.); (M.D.)
| | - Salvatore Scacco
- Department of Basic Medical Sciences and Neurosciences, University of Bari “Aldo Moro”, 70121 Bari, Italy
- Correspondence: (A.B.); (S.S.)
| | - Miriam Dellino
- Unit of Obstetrics and Gynaecology, Department of Biomedical Sciences and Human Oncology, 70132 Bari, Italy; (M.V.); (M.D.)
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Holland-Hall C. Self-Screening for Contraindications to Contraception: Are Adolescents up to the Task? J Adolesc Health 2021; 69:533-534. [PMID: 34489055 DOI: 10.1016/j.jadohealth.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Cynthia Holland-Hall
- Division of Adolescent Medicine, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
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