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Moore A, Ryan S, Stamm C. Seeking emergency contraception in the United States: A review of access and barriers. Women Health 2018; 59:364-374. [DOI: 10.1080/03630242.2018.1487905] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Alia Moore
- Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Correctional Health Services, Los Angeles County Department of Health Services, Los Angeles, California, USA
| | - Sarah Ryan
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
| | - Carol Stamm
- Division of General Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Al-Arifi MN. Community pharmacist perception and attitude toward ethical issues at community pharmacy setting in central Saudi Arabia. Saudi Pharm J 2014; 22:315-25. [PMID: 25161375 PMCID: PMC4142367 DOI: 10.1016/j.jsps.2013.08.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 08/31/2013] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The purpose of this study is to identify the community pharmacist perceptions and attitudes toward ethical issues at community pharmacy setting in Saudi Arabia. METHOD A cross-sectional, descriptive, and qualitative survey of community pharmacists was conducted and the survey questions were pre-tested by a pharmacist with extensive experience in ethical issues. Based on the result of a pilot study the questionnaire was used with some modifications and the final questionnaire was sent to the participants by handing over in person, mail or Email. RESULTS 45.7% Often discuss ethical issues with their patients, while only 2.1% never discuss it. 40.6% often record the ethical concern whereas only 1.9% of them never do so. 31.5% reported that patients initiate ethical issues. DISCUSSION 28.3% of the pharmacists initiate the discussion. The barriers that limit discussing ethical issues with their patients were lack of time due to other obligations assigned to the community pharmacist (69.2%), lack of reliable resources (10.7%), not interested in the subject (10.1%), lack of knowledge on ethical issues (4.8%), and other reasons (5.3%). Recourses are books (37.7%), internet web sites (31.1%), and brochures (26.8%). Only a minority of respondents had access to computer databases (15.8%) and other resources (1.3%). Most perceived ethical problems were: being asked for hormonal contraception, dispensing a drug for unreported indication (69.2%), dispensing dose of medicine for a child that is outside the SNF limits (68.9%), unwanted professional behavior about controlled drugs (66.6%), a colleague insisting on unethical behavior (65.0%), a colleague has done something unethical for the first time (64.7%), suspecting that a child is being abused (63.3%) prescribing on private scripts for suspected medications of possible abuse (60.7%) and terminally ill patient asks for a diagnosis or prognosis (52.9%). CONCLUSION The findings of this study assured the need of Saudi health authorities to implement a code of ethics for pharmacy practicing to cover all aspects of ethical issues.
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Affiliation(s)
- Mohamed N. Al-Arifi
- Clinical Pharmacy Department, Director of Drug and Poison Information Center, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Mollen CJ, Miller MK, Hayes KL, Barg FK. Knowledge, attitudes, and beliefs about emergency contraception: a survey of female adolescents seeking care in the emergency department. Pediatr Emerg Care 2013; 29:469-74. [PMID: 23528510 PMCID: PMC6747693 DOI: 10.1097/pec.0b013e31828a3249] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to assess urban adolescents' knowledge of and attitudes about emergency contraception (EC) and to assess the intention to use EC in particular hypothetical situations. We hypothesized that knowledge about EC would be limited, but that adolescents would support using EC in certain situations. METHODS A cross-sectional survey of English-speaking, 14- to 19-year-old adolescent girls presenting for care at 2 urban pediatric emergency departments. The survey was based on previous research with this target population and the constructs of the theory of planned behavior. RESULTS We enrolled 223 adolescents; 56% reported a history of sexual activity. Sixty-four percent stated that they had heard of EC. Participants with a history of sexual activity were more likely to have heard of EC compared with those without (odds ratio, 2.6; 95% confidence interval, 1.4-4.7), as were those 17 years and older (odds ratio, 2.3; 95% confidence interval, 1.2-4.3). The majority of participants were concerned about potential short-term and long-term adverse effects (86% and 78%, respectively); many participants were concerned about the cost of EC (45%) and about being able to get to a doctor for a prescription (45%). Participants supported using EC in the following situations: rape (88%), the condom breaks (82%), or no birth control was used (76%). Fewer supported using EC in the following situations: missed 1 oral contraceptive pill (51%) or first sexual experience (57%). CONCLUSIONS Participants indicated that although they would support EC use in several situations, they have concerns about EC use and access. Awareness of these factors and potential influences of EC use can guide providers toward effective counseling and interventions aimed to increase adolescents' use of EC in appropriate settings.
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Affiliation(s)
- Cynthia J Mollen
- Division of Emergency Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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Lee JK, Parisi SM, Baldauf E, Rapkin RB, Updike GM, Schwarz EB. Asking for what she needs? Pregnancy testing or EC? Contraception 2012; 87:859-63. [PMID: 23218857 DOI: 10.1016/j.contraception.2012.10.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 10/18/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND When used within 5 days of unprotected sex, emergency contraception (EC) can reduce the risk of pregnancy. Our objective was to explore how often women seeking clinic-based pregnancy testing who do not desire pregnancy might benefit from EC and examine variables associated with patients asking for EC when use is indicated. STUDY DESIGN Women seeking pregnancy testing or EC from an inner-city Title-X-funded family planning clinic between January 2011 and June 2012 were invited to complete surveys. RESULTS Twenty-seven percent (n=79) of respondents were seeking EC, and 73% (n=215) were seeking pregnancy testing. Of those seeking pregnancy testing, 39% might have benefited from same-day use of EC pills. Women who had never used EC and who had more than one episode of unprotected sex within the past month were less likely to request EC when use was indicated, while single women were more likely to request EC. CONCLUSIONS Counseling regarding EC options is particularly important for women seeking same-day pregnancy testing who do not desire pregnancy.
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Affiliation(s)
- Jessica K Lee
- University of Pittsburgh, Magee Women's Hospital, Pittsburgh, PA 15213, USA.
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Marcell AV, Waks AB, Rutkow L, McKenna R, Rompalo A, Hogan MT. What do we know about males and emergency contraception? A synthesis of the literature. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2012; 44:184-193. [PMID: 22958663 DOI: 10.1363/4418412] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
CONTEXT Unintended pregnancy rates are high in the United States. It is important to know whether improving males' access to emergency contraceptive pills may help prevent unintended pregnancy, especially in cases of -condom failure. METHODS A search of the PubMed, PsycINFO and Cumulative Index of Nursing and Allied Health Literature databases was conducted to identify studies published from January 1980 to April 2011 concerning males and emergency contraception. Forty-three studies met the specified criteria and examined relevant knowledge, attitudes, beliefs, intentions or behaviors, from the perspectives of males, clinicians or pharmacists. RESULTS The proportion of males who were familiar with emergency contraception ranged from 38% among teenagers to 65-100% among adults. Small proportions reported that they and their partner had used or discussed using emergency contraceptive pills (13-30%) or that they themselves had ever purchased them (11%). Most providers (77-85%) reported general knowledge about emergency contraceptives, but the proportions who knew the time frame within which the pills can be prescribed were smaller (28-63%). Most males approved of emergency contraceptive use following contraceptive failure (74-82%) or unprotected sex (59-65%), or in cases of rape (85-91%), but both pharmacists and college students reported concerns that females might feel pressured to use the method. No study examined clinicians' attitudes and behaviors (e.g., counseling or advance provision) regarding males and emergency contraception. CONCLUSIONS Studies are needed to determine whether male involvement in emergency contraception can reduce rates of unintended pregnancy and to assess health professionals' ability to counsel males about the method.
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Affiliation(s)
- Arik V Marcell
- Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Leder MR. Acute Sexual Assault and Evidence Collection in the DNA Era. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2012. [DOI: 10.1016/j.cpem.2012.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Attitudes and knowledge regarding emergency contraception among emergency department adolescents and providers. Pediatr Emerg Care 2012; 28:775-9. [PMID: 22858752 DOI: 10.1097/pec.0b013e3182627d14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Teen pregnancy is a public health issue in the United States. Emergency contraception (EC) has the potential to reduce teen pregnancy rates. The use of EC remains controversial, and barriers have been identified for adolescents seeking care. The objective of this study was to evaluate similarities and differences of knowledge and attitudes regarding EC among pediatric emergency department (PED) female adolescents, nurses, and physicians/nurse practitioners (NPs). METHODS A quantitative survey including demographics, knowledge, and attitudes regarding EC was administered to 3 groups: (1) PED nurses, (2) PED physicians and NPs, and (3) adolescent female patients seeking care in the PED. Demographic data were analyzed using descriptive statistics. Differences between groups were analyzed using Student t test for continuous variables and χ or Fisher exact test for categorical variables. Attitude and knowledge differences among the groups were analyzed using the nonparametric Wilcoxon test. RESULTS There was no difference in overall knowledge regarding EC between nurses and physicians/NPs, adolescents and nurses or adolescents and physicians/NPs, and overall knowledge was poor among all groups. There was no difference in overall attitudes between nurses and adolescents; however, physicians were more liberal in their attitudes regarding EC compared with adolescents (P < 0.0001) and nurses (P < 0.0001). Older age trended toward more conservative responses (P = 0.05). CONCLUSIONS Adolescents and nurses had more conservative attitudes toward EC than physicians. Further studies are needed to confirm the generalizability of these findings.
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Spezielle Arzneimitteltherapie in der Schwangerschaft. ARZNEIMITTEL IN SCHWANGERSCHAFT UND STILLZEIT 2012. [PMCID: PMC7271212 DOI: 10.1016/b978-3-437-21203-1.10002-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Child sexual abuse is a common pediatric problem that concerns all pediatric health care providers. Management of child sexual abuse is multifaceted and multidisciplinary. Specialized health providers can provide consultation, but this availability does not minimize the role of the referring physician who often has ongoing contact with the family. Physicians are mandated to report cases of suspected or confirmed sexual abuse. In the majority of cases, a child’s statement about sexual abuse is the strongest evidence that abuse has occurred. Physical examination is normal in the majority of sexual abuse victims. Accurate, evidence-based interpretation of physical and laboratory findings is essential. Normal examinations, normal variants, and findings indicative of sexual contact must be differentiated. Forensic evidence collection and prophylactic treatments may be indicated when patients present within 72 hours of an abusive episode, and patients should be triaged accordingly. Potentially negative psychosocial outcomes should be addressed for patients and their families on initial evaluation and follow-up.
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Affiliation(s)
- Kristine Fortin
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Pitts SAB, Corliss HL, Kharasch SJ, Gordon CM. Advance provision of emergency contraception in an urban pediatric emergency department. J Pediatr Adolesc Gynecol 2011; 24:392-6. [PMID: 22099732 DOI: 10.1016/j.jpag.2011.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 05/26/2011] [Accepted: 05/31/2011] [Indexed: 12/30/2022]
Abstract
STUDY OBJECTIVE To assess whether a policy and educational intervention in an urban, pediatric emergency department (ED) increases advance provision of emergency contraception (EC) to patients. DESIGN/SETTING/PARTICIPANTS A pre- and post-intervention, retrospective chart review was conducted in an urban, pediatric ED assessing provider care of sexually active female adolescents and young adults. INTERVENTION/MAIN OUTCOME MEASURES: A policy was instituted recommending that ED providers prescribe EC and provide an educational handout to all sexually active female adolescents and young adults. ED providers were educated about EC and this policy. Charts, subsequently reviewed, included sexually active female patients, age 13-21 years, presenting to the ED status post sexual assault, seeking EC, or with an abdominal, gynecologic, or urologic complaint. Student's t-tests, Pearson's chi-square and Fisher's Exact tests compared pre- and post-intervention provider and patient characteristics and outcomes. RESULTS The mean age of the patient sample was 18.8 years (SD=1.7), 83% were Black or Hispanic, 43% were previously pregnant, 25% reported not using birth control. Last unprotected sexual intercourse was not documented for 87% of patients presenting with medical complaints. There was no difference in the advance prescribing of EC or the provision of the educational handout to patients pre- (3.3%) or post- (5.6%) intervention (P = 0.73). CONCLUSIONS Despite a policy and an educational intervention for providers, little change occurred in advance EC prescribing in an urban, pediatric ED. Additionally, many providers were not documenting last unprotected sexual intercourse, potentially missing an opportunity to treat patients with EC at the time of their visit.
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Affiliation(s)
- Sarah A B Pitts
- Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Boston, Massachusetts, USA.
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Abstract
Male adolescents' sexual and reproductive health needs often go unmet in the primary care setting. This report discusses specific issues related to male adolescents' sexual and reproductive health care in the context of primary care, including pubertal and sexual development, sexual behavior, consequences of sexual behavior, and methods of preventing sexually transmitted infections (including HIV) and pregnancy. Pediatricians are encouraged to address male adolescent sexual and reproductive health on a regular basis, including taking a sexual history, performing an appropriate examination, providing patient-centered and age-appropriate anticipatory guidance, and delivering appropriate vaccinations. Pediatricians should provide these services to male adolescent patients in a confidential and culturally appropriate manner, promote healthy sexual relationships and responsibility, and involve parents in age-appropriate discussions about sexual health with their sons.
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McIntosh J, Rafie S, Wasik M, McBane S, Lodise NM, El-Ibiary SY, Forinash A, Kachlic MD, Rowe E, Besinque K. Changing oral contraceptives from prescription to over-the-counter status: an opinion statement of the Women's Health Practice and Research Network of the American College of Clinical Pharmacy. Pharmacotherapy 2011; 31:424-37. [PMID: 21449630 DOI: 10.1592/phco.31.4.424] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Addressing the issue of unintended pregnancy is a national priority. One proposed strategy to reduce unintended pregnancy is to improve access to oral contraceptives by changing them to over-the-counter (OTC) status. Existing data indicate that oral contraceptives meet safety criteria required of OTC products. Available literature demonstrates that women can self-screen for contraindications to oral contraceptives and can do this as well as clinicians, and experience with OTC emergency contraception suggests that OTC oral contraceptives would not increase sexual risk-taking behavior. Women support OTC access to oral contraceptives, but express an interest in accessing pharmacist counseling. On the basis of these data, the Women's Health Practice and Research Network of the American College of Clinical Pharmacy supports changing oral contraceptives to OTC status under two conditions: that they are sold where a pharmacist is on duty and that there are mechanisms in place to cover OTC contraceptives through Medicaid. Future research should address the issues of out-of-pocket costs to individuals, label-comprehension studies, and models for pharmacist reimbursement for time spent counseling on contraception.
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Affiliation(s)
- Jennifer McIntosh
- School of Pharmacy, Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts, USA.
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Miller MK, Plantz DM, Dowd MD, Mollen CJ, Reed J, Vaughn L, Gold MA. Pediatric emergency health care providers' knowledge, attitudes, and experiences regarding emergency contraception. Acad Emerg Med 2011; 18:605-12. [PMID: 21676058 DOI: 10.1111/j.1553-2712.2011.01079.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The objective was to describe knowledge, attitudes, and experiences regarding emergency contraception (EC) among pediatric emergency health care providers (HCPs). METHODS This multicenter, focus group study elicited thoughts and experiences from pediatric emergency HCPs about EC. Participants were physicians, nurse practitioners (NPs), and nurses in one of three urban, geographically distinct, pediatric emergency departments (EDs). A professional moderator used a semistructured format for sessions, which were audiotaped, transcribed, and analyzed for recurrent themes. Participants provided demographic information and completed a written survey evaluating EC knowledge. RESULTS Eighty-five HCPs (41 physicians, eight NPs, and 36 nurses) participated in 12 focus groups. Overall knowledge about EC was poor. Participants identified barriers including cost, privacy, knowledge, and provider refusal. Provision of EC for adolescents was supported by the majority of physicians and NPs; however, many nurses were not supportive, especially following consensual intercourse. The authors identified use of social judgment by nurses as a novel barrier to EC provision. The majority of HCPs did not support screening for potential EC need. The majority of physicians and NPs felt obligated to provide adolescents with all contraceptive options, while more nurses supported provider refusal to provide EC. CONCLUSIONS This study identified important HCP perceptions and barriers about EC provision in the pediatric ED. These findings may inform future efforts to improve EC provision for adolescents. Specifically, future studies to evaluate the differences in attitudes between nurses, physicians, and NPs, and the use of social judgment in EC provision, are warranted.
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Affiliation(s)
- Melissa K Miller
- Division of Emergency Medical Services, Children's Mercy Hospital, Kansas City, MO, USA.
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Kavanaugh ML, Williams SL, Schwarz EB. Emergency contraception use and counseling after changes in United States prescription status. Fertil Steril 2011; 95:2578-81. [PMID: 21457957 DOI: 10.1016/j.fertnstert.2011.03.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 02/16/2011] [Accepted: 03/05/2011] [Indexed: 11/26/2022]
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Jurow R. Emergency Contraception. Contraception 2011. [DOI: 10.1002/9781444342642.ch13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Clowse MEB. Managing contraception and pregnancy in the rheumatologic diseases. Best Pract Res Clin Rheumatol 2010; 24:373-85. [PMID: 20534371 DOI: 10.1016/j.berh.2009.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Most pregnancies in women with rheumatologic disease will result in the delivery of a healthy baby. Pregnancy can be particularly risky in women with active disease or on teratogenic medications, making contraception an important issue for these women. All women with rheumatologic disease have contraceptive options, including barrier methods, the intra-uterine device and progesterone-only medications. Active inflammatory disease, whether in the form of lupus, systemic vasculitis or myositis, places the pregnancy at increased risk. Pre-eclampsia is a particular risk for women with lupus or antiphospholipid syndrome and may be decreased by daily low-dose aspirin. Rheumatoid arthritis typically improves and does not have a major impact on pregnancy outcomes. The expected post-partum arthritis flare may be avoided by restarting medications soon after delivery. Judicious use of medication and close observation may be the keys to successful pregnancy in women with rheumatologic disease.
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Affiliation(s)
- Megan E B Clowse
- Department of Rheumatology & Immunology Duke University Health System, Durham, UK.
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Braverman PK, Breech L. American Academy of Pediatrics. Clinical report--gynecologic examination for adolescents in the pediatric office setting. Pediatrics 2010; 126:583-90. [PMID: 20805151 DOI: 10.1542/peds.2010-1564] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The American Academy of Pediatrics promotes the inclusion of the gynecologic examination in the primary care setting within the medical home. Gynecologic issues are commonly seen by clinicians who provide primary care to adolescents. Some of the most common concerns include questions related to pubertal development; menstrual disorders such as dysmenorrhea, amenorrhea, oligomenorrhea, and abnormal uterine bleeding; contraception; and sexually transmitted and non-sexually transmitted infections. The gynecologic examination is a key element in assessing pubertal status and documenting physical findings. Most adolescents do not need an internal examination involving a speculum or bimanual examination. However, for cases in which more extensive examination is needed, the primary care office with the primary care clinician who has established rapport and trust with the patient is often the best setting for pelvic examination. This report reviews the gynecologic examination, including indications for the pelvic examination in adolescents and the approach to this examination in the office setting. Indications for referral to a gynecologist are included. The pelvic examination may be successfully completed when conducted without pressure and approached as a normal part of routine young women's health care.
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Adamji JM, Swartwout K. Advance provision of emergency contraception for adolescents. J Sch Nurs 2010; 26:443-9. [PMID: 20693415 DOI: 10.1177/1059840510377765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Emergency contraception is most effective at preventing unintended pregnancy when taken as early as possible following unprotected sexual intercourse. Advance provision of this medication supports more timely and effective use. In the midst of rising teen pregnancy rates, current policies often limit access to emergency contraception for adolescents. A literature search identified three recent experimental studies of advance provision for adolescents. This article reviews those studies and finds strong support for advance provision for adolescents. Usage of emergency contraception increased with advance provision and there was no increase in negative sexual behaviors or decrease in usage of other contraceptive forms. Implications of these findings for school nurses and school-based health center staff are also discussed.
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Affiliation(s)
- Jehan-Marie Adamji
- Rush School Based Health Centers at Crane and Orr High Schools, Rush University College of Nursing, Chicago, IL, USA
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22
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Katzman DK, Taddeo D. La contraception d'urgence. Paediatr Child Health 2010. [DOI: 10.1093/pch/15.6.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Trends in inequalities in induced abortion according to educational level among urban women. J Urban Health 2010; 87:524-30. [PMID: 20229107 PMCID: PMC2871088 DOI: 10.1007/s11524-009-9394-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Accepted: 07/16/2009] [Indexed: 10/19/2022]
Abstract
This study aims to describe trends in inequalities by women's socioeconomic position and age in induced abortion in Barcelona (Spain) over 1992-1996 and 2000-2004. Induced abortions occurring in residents in Barcelona aged 20 and 44 years in the study period are included. Variables are age, educational level, and time periods. Induced abortion rates per 1,000 women and absolute differences for educational level, age, and time period are calculated. Poisson regression models are fitted to obtain the relative risk (RR) for trends. Induced abortion rates increased from 10.1 to 14.6 per 1,000 women aged 20-44 (RR = 1.44; 95% confidence interval (CI) 1.41-1.47) between 1992-1996 and 2000-2004. The abortion rate was highest among women aged 20-24 and 25-34 and changed little among women aged 35-44. Among women aged 20-24 and 25-34, those with a primary education or less had higher rates of induced abortion in the second period. Induced abortion rates also grew in those women with secondary education. In the 35-44 age group, the induced abortion rate declined among women with a secondary education (RR = 0.66; 95% CI 0.60-0.73) and slightly among those with a greater level of education. Induced abortion is rising most among women in poor socioeconomic positions. This study reveals deep inequalities in induced abortion in Barcelona, Spain. The trends identified in this study suggest that policy efforts to reduce unintended pregnancies are failing in Spain. Our study fills an important gap in literature on recent trends in Southern Europe.
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Johnson R, Nshom M, Nye AM, Cohall AT. There's always Plan B: adolescent knowledge, attitudes and intention to use emergency contraception. Contraception 2010; 81:128-32. [DOI: 10.1016/j.contraception.2009.08.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Revised: 08/13/2009] [Accepted: 08/19/2009] [Indexed: 11/27/2022]
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Nguyen BT, Zaller N. Pharmacy provision of emergency contraception to men: A survey of pharmacist attitudes in Rhode Island. J Am Pharm Assoc (2003) 2010; 50:17-23. [PMID: 20097635 DOI: 10.1331/japha.2010.08183] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Brian T Nguyen
- Warren Alpert Medical School, Division of Medicine, Brown University, Providence, RI 02912-9107, USA.
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Patient characteristics and provider practice patterns for emergency contraception in a pediatric emergency department. Pediatr Emerg Care 2010; 26:6-9. [PMID: 20042915 DOI: 10.1097/pec.0b013e3181c32ec9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe epidemiologic and clinical characteristics of patients receiving emergency contraception (EC) in a pediatric emergency department (ED), practice variations for EC, and ED return visits after EC. METHODS This single-site study describes all patients who received oral EC (1.5-mg levonorgestrel) in the ED from January 1, 2003 to December 31, 2007. A chart review provided patient demographics, history, examination findings, treatment, and ED return visits within 7 days. RESULTS There were 116 patients with a mean age of 13.7 years; half were white, and most (69.8%) had Medicaid. The most common presenting complaint was nonconsensual sex or sexual assault (87.9%). Most patients (89.6%) reported last sexual contact within 72 hours of presentation. Half of the patients (50%) received 1.5-mg levonorgestrel in a single dose, and there was a significant trend toward single-dose distribution during the study (P < 0.001). Patient presentation was most common from 8 pm to midnight (P < 0.001). Most received a pregnancy test (98.3%), a pelvic bimanual or speculum examination (81.9%), and prophylactic or immediate treatment of a sexually transmitted infection (88.8%). No prescriptions for future EC were given. One patient returned to the ED 1 day after receiving EC complaining of nausea and blurry vision. CONCLUSIONS Reviewing recipients of EC from a pediatric ED suggests education is needed for both health care providers and adolescents. Although providers are generally following the most recent dosing guidelines, opportunities to prescribe EC to adolescent girls with complaints other than sexual assault seem to be missed.
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Policy statement--Physician refusal to provide information or treatment on the basis of claims of conscience. Pediatrics 2009; 124:1689-93. [PMID: 19948636 DOI: 10.1542/peds.2009-2222] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Health care professionals may have moral objections to particular medical interventions. They may refuse to provide or cooperate in the provision of these interventions. Such objections are referred to as conscientious objections. Although it may be difficult to characterize or validate claims of conscience, respecting the individual physician's moral integrity is important. Conflicts arise when claims of conscience impede a patient's access to medical information or care. A physician's conscientious objection to certain interventions or treatments may be constrained in some situations. Physicians have a duty to disclose to prospective patients treatments they refuse to perform. As part of informed consent, physicians also have a duty to inform their patients of all relevant and legally available treatment options, including options to which they object. They have a moral obligation to refer patients to other health care professionals who are willing to provide those services when failing to do so would cause harm to the patient, and they have a duty to treat patients in emergencies when referral would significantly increase the probability of mortality or serious morbidity. Conversely, the health care system should make reasonable accommodations for physicians with conscientious objections.
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Bastos S, Bonfim JRDA, Kalckmann S, Figueiredo R, Fernandes MEL. Prevenção de doenças sexualmente transmissíveis e procura da contracepção de emergência em farmácias e drogarias do município de São Paulo. SAUDE E SOCIEDADE 2009. [DOI: 10.1590/s0104-12902009000400021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
São apresentados aspectos da experiência do projeto de intervenção educativa voltado à prevenção de doenças sexualmente transmissíveis e da síndrome de imunodeficiência adquirida (DST/Aids) realizado com profissionais de farmácias e drogarias da área metropolitana de São Paulo. Discute-se a aquisição de contracepção de emergência como importante motivo de procura de farmácias e drogarias e seu uso como fonte de dúvidas para os profissionais. Concluiu-se que a intervenção educativa, realizada pelos profissionais nos estabelecimentos farmacêuticos, contribui na prevenção de DST/Aids, visto que o balcão de farmácia é meio frequentemente utilizado pela população na busca por orientação e indicação de produtos farmacêuticos, além de informações sobre saúde. Pode-se afirmar que é possível e indispensável a incorporação dessa estratégia educativa na prevenção de DST/Aids por estabelecimentos farmacêuticos, em situações cotidianas de risco ou preocupação com doenças presumíveis e com a gravidez por meio de proposição de condutas eficazes de saúde para a população. Extraíram-se lições sobre a experiência quanto à importância de ações de educação para jovens e para profissionais de farmácias em que se enfatizem os direitos sexuais e reprodutivos e a promoção do uso racional de fármacos.
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Upadhya KK, Trent ME, Ellen JM. Impact of individual values on adherence to emergency contraception practice guidelines among pediatric residents: implications for training. ACTA ACUST UNITED AC 2009; 163:944-8. [PMID: 19805714 DOI: 10.1001/archpediatrics.2009.160] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To evaluate the impact of individual, system, and interpersonal factors on emergency contraception practices. We hypothesized that abortion attitudes and attitudes toward teen sex would be significant individual factors influencing emergency contraception practices. DESIGN This was a cross-sectional, anonymous Internet survey. SETTING Four pediatric residency programs in the Baltimore, Maryland-Washington, DC, metropolitan area during April to June 2007. PARTICIPANTS One hundred forty-one pediatric residents completed the survey. MAIN EXPOSURE Abortion attitudes were assessed by participants' level of agreement with abortion in 7 scenarios. Attitudes toward teen sex were assessed by participants' level of agreement with 5 statements about the acceptability of teens having sex. MAIN OUTCOME MEASURES Emergency contraceptive counseling behavior was assessed by reported frequency of including emergency contraception in routine contraceptive counseling. Intention to prescribe emergency contraception was assessed by reported likelihood of prescribing in 5 scenarios. RESULTS When controlling for demographics and other predictors, residents with less favorable abortion attitudes were more likely to have the lowest intention to prescribe emergency contraception. Residents with more positive attitudes toward teen sex and who had a preceptor encourage emergency contraception prescription were more likely to include emergency contraception in routine contraceptive counseling most/all the time and to have the highest intention to prescribe. CONCLUSION Efforts to challenge and affect attitudes toward teen sex and to prompt residents to prescribe emergency contraception in clinical settings may be needed to encourage more proactive emergency contraceptive practice in accordance with national practice guidelines.
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Affiliation(s)
- Krishna K Upadhya
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, U SA.
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Ragland D, West D. Pharmacy students' knowledge, attitudes, and behaviors regarding emergency contraception. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2009; 73:26. [PMID: 19513164 PMCID: PMC2690901 DOI: 10.5688/aj730226] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To determine pharmacy students' knowledge, attitudes, and behaviors regarding emergency contraception. METHODS A cross-sectional survey was conducted among a convenience sample of students prior to a regular class period. The 16-item survey instrument included both multiple-choice and true/false questions to assess knowledge and Likert-type scale questions regarding attitudes and behaviors. Frequency and descriptive statistics were calculated for all variables. RESULTS Three hundred one pharmacy students were surveyed. Eighty-seven percent knew that Plan B had been approved by the Food and Drug Administration (FDA) for nonprescription use, yet 33% believed that it worked by disrupting a newly implanted ovum. On a scale from 1-5 on which 5 = strongly agree, the mean item score was 1.5 for whether nonprescription emergency contraception should be available without counseling by a pharmacist, yet only 26.7% believed they were competent instructing patients on the use of emergency contraception. CONCLUSIONS Additional education is needed to prepare pharmacy students to provide informed pharmaceutical care to patients seeking emergency contraception, especially given the passage of legislation making the pharmacy the point of access for some emergency contraception products.
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Affiliation(s)
- Denise Ragland
- College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
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Emergency contraception services for adolescents: a National Survey of Children's Hospital Emergency Department Directors. J Pediatr Adolesc Gynecol 2009; 22:111-9. [PMID: 19345917 DOI: 10.1016/j.jpag.2008.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Revised: 03/26/2008] [Accepted: 04/01/2008] [Indexed: 11/24/2022]
Abstract
STUDY OBJECTIVE To assess emergency contraception (EC) counseling and prescribing practices of children's hospital emergency department (ED) directors and the use of EC protocols in these settings. DESIGN Cross-sectional study of children's hospital ED directors responding to a 15-minute 44-item semi-structured survey during telephone interviews. PARTICIPANTS 50 of 96 eligible directors of children's hospital EDs in the United States. MAIN OUTCOME MEASURES EC protocols, EC counseling processes, EC prescribing practices. RESULTS Most (80%) ED directors reported always offering EC as part of sexual assault care; 66% were more likely to provide onsite EC in these situations. Only 52% identified the progestin-only regimen as the EC dispensed in their ED, and most (96%) limited provision to fewer than 120 hours after sex. Although 58% of ED directors reported ever prescribing ongoing contraception when providing EC, none had prescribed EC for future use. Written ED protocols for providing EC were more common for sexual assault care (76%) than for non-sexual assault care (14%). Directors who worked at hospitals with a sexual assault program were less likely to discuss all the recommended topics for EC counseling. CONCLUSIONS The recommended standard of care for providing EC to adolescents in children's hospital EDs is not being met. Although risk of pregnancy following sexual assault and consensual unprotected sex is identical, discrepant practices emerged from this survey of pediatric ED directors. Increased education and policy initiatives within children's hospital EDs are needed to standardize EC services for adolescents in this setting.
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Goyal M, Zhao H, Mollen C. Exploring emergency contraception knowledge, prescription practices, and barriers to prescription for adolescents in the emergency department. Pediatrics 2009; 123:765-70. [PMID: 19255000 DOI: 10.1542/peds.2008-0193] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The objective of this study was to assess the proportion of emergency medicine physicians who had prescribed emergency contraception pills to adolescents, to identify potential barriers to emergency contraception pill prescription for adolescents, and to assess physician knowledge of emergency contraception pills. PARTICIPANTS AND METHODS A cross-sectional, anonymous, Internet-based survey of members of the American Academy of Pediatrics Section of Emergency Medicine was conducted. Providers were included in analysis if they were attending physicians caring for children (<22 years of age) in the emergency department setting >30% of the time. Survey questions included demographics, emergency contraception pill prescription rates for adolescents, attitudes toward emergency contraception pills for adolescents, and emergency contraception pill knowledge questions. RESULTS A total of 1005 Section of Emergency Medicine members were contacted; 424 (42%) responded, and 133 did not meet inclusion criteria. Of the 291 eligible respondents, 282 had complete surveys. Eighty-five percent of the respondents stated that they had prescribed emergency contraception pills to adolescents, 71% within the previous year. Of those, 81% prescribed emergency contraception pills <5 times. The 5 most frequently cited barriers were concern for lack of follow-up (72%), time constraints (40%), lack of clinical resources (33%), discouraging regular contraceptive use (29%), and concern about birth defects (27%). Thirty-nine percent of respondents identified >/=5 barriers to emergency contraception pill prescriptions for adolescents. Forty-three percent incorrectly answered >50% of the questions. Physicians were more likely to report prescribing emergency contraception pills if they had answered >3 of the knowledge-based questions correctly and were less likely to report prescribing if they identified >5 barriers. CONCLUSIONS Although a large proportion of emergency department physicians reported prescribing emergency contraception pills to adolescents, the pills were prescribed infrequently. Factors associated with nonprescription were decreased knowledge of emergency contraception pills and identifying >5 barriers. Identification of these potential barriers and education regarding emergency contraception pills may ultimately improve adolescent access to emergency contraception pills in the emergency department.
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Affiliation(s)
- Monika Goyal
- Children's Hospital of Philadelphia, Division of Emergency Medicine, 3400 Civic Center Blvd, Philadelphia PA 19104, USA.
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Lee I. Child sexual abuse and pediatricians. KOREAN JOURNAL OF PEDIATRICS 2009. [DOI: 10.3345/kjp.2009.52.11.1200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Insil Lee
- Department of Pediatrics, National Police Hospital, Seoul, Korea
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Hopkins D, West D. Arkansas pharmacists' perceptions toward emergency contraception and nonprescription Plan B. Pharm Pract (Granada) 2008; 6:98-102. [PMID: 25157288 PMCID: PMC4141872 DOI: 10.4321/s1886-36552008000200007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2008] [Accepted: 05/27/2008] [Indexed: 12/30/2022] Open
Abstract
Objective This study describes Arkansas pharmacists’ knowledge, attitudes, and beliefs regarding emergency contraception. Methods A cross-sectional survey was conducted among a convenience sample of pharmacists prior to a continuing education lecture. The 16-item survey included multiple choice and true/false questions to assess knowledge in addition to Likert-type scale questions regarding attitudes and beliefs. Frequency and descriptive statistics were calculated for all variables. Results Eighty-eight pharmacists completed the survey. A majority (73%) knew that Plan B had been FDA-approved for nonprescription use yet 42% believed that it works by disrupting a newly implanted ovum. On a scale from 1-5 where 5=strongly agree, the mean item score was 3.2 for whether emergency contraception should be available for nonprescription use with counseling and 1.6 for nonprescription use without counseling. When asked what they would do if presented with a request for emergency contraception, 45.8% indicated they would dispense the drug, 22.9% would refer the patient to another pharmacist or pharmacy, 3.6% would refuse to dispense, and 27.7% were not sure. Almost half (48.6%) did not believe they were competent instructing patients on the use of emergency contraception. Conclusions The results show that pharmacists could benefit from additional training on emergency contraception.
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Affiliation(s)
- Denise Hopkins
- College of Pharmacy, University of Arkansas for Medical Sciences . Little Rock, Arkansas ( USA )
| | - Donna West
- College of Pharmacy, University of Arkansas for Medical Sciences . Little Rock, Arkansas ( USA )
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Stanford JB. Emergency contraception: overestimated effectiveness and questionable expectations. Clin Pharmacol Ther 2008; 83:19-21. [PMID: 18030305 DOI: 10.1038/sj.clpt.6100442] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- J B Stanford
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah, USA.
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Socioeconomic inequalities in unintended pregnancy and abortion decision. J Urban Health 2008; 85:125-35. [PMID: 18038210 PMCID: PMC2430141 DOI: 10.1007/s11524-007-9233-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2007] [Accepted: 10/11/2007] [Indexed: 01/27/2023]
Abstract
Pregnancy planning allows women to better control their life trajectory and contributes to the future child's health and development. Many studies that have analyzed socioeconomic inequalities in unintended pregnancy only took into account those pregnancies ending in births. Few of them that analyzed unintended pregnancy, including both induced abortion and births, and its socioeconomic determinants, concluded that unintended pregnancy is more frequent in young, poor, or unmarried women. These inequalities have been poorly studied in Europe, especially in the southern European context. The aim of the present study is to describe socioeconomic inequalities in unintended pregnancy and in abortion decision in Barcelona, Spain. The major findings are that unintended pregnancies accounted for 41% of total pregnancy and of these, 60% ended in abortion. From all pregnancies, the proportion of induced abortion reached 25.6%. Compared to women with university studies, those with primary education incomplete had more unintended pregnancies (OR=7.22). When facing an unintended pregnancy, women of lower socioeconomic position are more likely to choose induced abortion, although this is not the case among young or single women. This study reveals deep socioeconomic inequalities in unintended pregnancies and abortion decision in Barcelona, Spain, where the birth rate is very low and the abortion rate is rising. Women in low socioeconomic positions have many more unintended pregnancies than better educated women. Except for young or single women, the lower the socioeconomic position, the higher the proportion of women who choose an induced abortion when facing an unintended pregnancy.
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Saito MI, Leal MM. Adolescência e contracepção de emergência: Fórum 2005. REVISTA PAULISTA DE PEDIATRIA 2007. [DOI: 10.1590/s0103-05822007000200014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJETIVO: Relatar os resultados do Fórum "Adolescência e Contracepção de Emergência", que teve como proposta trazer maiores esclarecimentos sobre a contracepção de emergência (CE), além de apoio ético e técnico para sua prescrição, a partir da análise de três vertentes principais de discussão: o perfil da clientela adolescente; as questões éticas que envolvem a CE; a eficácia e o risco do método. FONTES DE DADOS: Discussão dos temas propostos a partir da literatura atual sobre o tema do Fórum organizado em 2005, que envolveu a participação de pediatras, ginecologistas, profissionais ligados a Comissões de Bioética, ao Conselho Federal de Medicina e ao Ministério da Saúde, advogados e juízes. SÍNTESEDOS DADOS: A adolescência caracteriza-se por mudanças, transformações e experimentações que vinculam essa fase da vida à vulnerabilidade e risco. Alguns desses riscos estão relacionados ao exercício inadvertido ou impensado da sexualidade, cujas conseqüências são bem conhecidas: gravidez precoce, aborto e doenças sexualmente transmissíveis, entre as quais HPV e AIDS. É fundamental, portanto, que a assistência a essa faixa etária inclua o enfoque de prevenção, na qual a educação sexual seja vista como um processo do qual é parte relevante a orientação anticoncepcional, incluindo-se nesta a contracepção em situações de emergência. CONCLUSÕES: O artigo apresenta as conclusões resultantes das discussões realizadas durante esse evento. Seu principal desdobramento foi a Resolução do Conselho Federal de Medicina: a CE não é abortiva e pode ser usada em qualquer etapa da vida reprodutiva.
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Hansen LB, Saseen JJ, Teal SB. Levonorgestrel-Only Dosing Strategies for Emergency Contraception. Pharmacotherapy 2007; 27:278-84. [PMID: 17253917 DOI: 10.1592/phco.27.2.278] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The United States Food and Drug Administration-approved progestin-only dosing strategy for emergency contraception is levonorgestrel 0.75 mg taken as soon as possible within 72 hours of unprotected intercourse, with a second 0.75-mg dose taken 12 hours later. However, different dosing strategies have been studied and promoted by various organizations. The American College of Obstetricians and Gynecologists recommends a single dose of levonorgestrel 1.5 mg for emergency contraception as one option. As another option, they recommend two doses of levonorgestrel 0.75 mg may be effective when taken 12-24 hours apart. We performed a search of MEDLINE and International Pharmaceutical Abstracts from 1967-2006 to evaluate and describe the existing pharmacokinetic and patient outcome data regarding administration of levonorgestrel as a 1.5-mg single dose or two 0.75-mg doses taken 12 or 24 hours apart. Additional studies were identified from the bibliographies of the selected literature. Several pertinent articles were identified. All of the studies demonstrated that emergency contraception effectively prevented pregnancy. In addition, evidence supports the safety and efficacy of a single dose of levonorgestrel 1.5 mg for emergency contraception. Furthermore, when two doses of levonorgestrel 0.75 mg are administered, the second dose can confidently be taken 12-24 hours after the first without compromising efficacy. Understanding the evidence that supports the different emergency contraception dosing strategies is critical for clinicians, and especially pharmacists, who have interactive roles in dispensing emergency contraception.
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Affiliation(s)
- Laura B Hansen
- Department of Clinical Pharmacy, University of Colorado at Denver and Health Sciences Center, Denver, Colorado 80262-0238, USA
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Paul IM. Advances in pediatric pharmacology, therapeutics, and toxicology. Adv Pediatr 2007; 54:29-53. [PMID: 17918465 DOI: 10.1016/j.yapd.2007.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ian M Paul
- Department of Pediatrics, The Milton S. Hershey Medical Center, Penn State College of Medicine, 500 University Drive, H085, Hershey, PA 17033, USA.
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Abstract
Despite recent improvements in rates of teen pregnancy, abortion, birth,and contraceptive use, effective contraceptive counseling for adolescents should be a high priority for the primary care provider in the office setting. Adolescent psychosocial risk screening and appropriate counseling about sexual decision-making is necessary. Contraceptive services visits include, relevant history, limited physical examination, provision of information, anticipatory guidance about sexual behaviors, and the provision of contraceptive methods. Teens should always be encouraged to use a male condom during sex to reduce STI risk. A variety of barrier and hormonal contraceptive methods are available for the adolescent population. Education about and provision of EC is effective in reducing the rate of unintended pregnancy and abortion in the United States. Contraceptive care for adolescents is a rewarding experience for primary care providers.
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Affiliation(s)
- Elizabeth Feldman
- Department of Family Medicine, University of Illinois at Chicago, USA.
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43
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Sarkar NN. Emergency contraception: a contraceptive intervention approaching target despite controversy and opposition. J Public Health (Oxf) 2006. [DOI: 10.1007/s10389-006-0036-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Gold MA. Emergency contraception: to the editor. Pediatrics 2006; 117:1448-50; author reply 1450. [PMID: 16585349 DOI: 10.1542/peds.2005-2811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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45
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Stanford JB, Mikolajczyk RT. Emergency contraception. Pediatrics 2006; 117:1448; author reply 1450. [PMID: 16585350 DOI: 10.1542/peds.2005-2491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Spezielle Arzneimitteltherapie in der Schwangerschaft. ARZNEIVERORDNUNG IN SCHWANGERSCHAFT UND STILLZEIT 2006. [PMCID: PMC7271219 DOI: 10.1016/b978-343721332-8.50004-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Generali J. Recent Publications on Medications and Pharmacy. Hosp Pharm 2005. [DOI: 10.1177/001857870504001212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hospital Pharmacy presents this new feature to keep pharmacists abreast of new publications in the medical/pharmacy literature. Articles of interest will be abstracted monthly regarding a broad scope of topics.
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Affiliation(s)
- Joyce Generali
- Drug Information Center, Kansas University Medical Center, Kansas City, KS
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