Emergency contraception: randomized comparison of advance provision and information only

Ellertson, Charlotte; Ambardekar, Shubba; Hedley, Allison; Coyaji, Kurus; Trussell, James; Blanchard, Kelly

doi:10.1016/s0029-7844(01)01506-x

Cited by 90 publications

(41 citation statements)

References 5 publications

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“…213 There are no medical contraindications to this method, and multiple studies have found that providing EC in advance increases the likelihood of women using it when it is needed and does not increase sexual or contraceptive risktaking behavior. 215,216 Given the sometimes sporadic and unplanned nature of adolescent sexual behavior, counseling and advance provision of EC should be a part of anticipatory guidance.…”

Section: Male Condomsmentioning

confidence: 99%

Contraception for Adolescents

Ott

Sucato²

2014

Pediatrics

245

133

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A working knowledge of contraception will assist the pediatrician in both sexual health promotion as well as treatment of common adolescent gynecologic problems. Best practices in adolescent anticipatory guidance and screening include a sexual health history, screening for pregnancy and sexually transmitted infections, counseling, and if indicated, providing access to contraceptives. Pediatricians’ long-term relationships with adolescents and families allow them to help promote healthy sexual decision-making, including abstinence and contraceptive use. Additionally, medical indications for contraception, such as acne, dysmenorrhea, and heavy menstrual bleeding, are frequently uncovered during adolescent visits. This technical report provides an evidence base for the accompanying policy statement and addresses key aspects of adolescent contraceptive use, including the following: (1) sexual history taking, confidentiality, and counseling; (2) adolescent data on the use and side effects of newer contraceptive methods; (3) new data on older contraceptive methods; and (4) evidence supporting the use of contraceptives in adolescent patients with complex medical conditions.

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Section: Male Condomsmentioning

confidence: 99%

Contraception for Adolescents

Ott

Sucato²

2014

Pediatrics

245

133

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“…Providing EC in advance increases the likelihood of use when it is needed without increasing sexual or contraceptive risk-taking behavior. 143,144 Therefore, EC should be prescribed or recommended in advance for use for up to 5 days after an event of unprotected intercourse. 44 Additional details on EC mechanisms and use can be found in the AAP policy statement on emergency contraception 44 and the accompanying technical report.…”

Section: Emergency Contraceptionmentioning

confidence: 99%

Contraception for Adolescents

Braverman¹,

Adelman²,

Alderman³

et al. 2014

Pediatrics

311

107

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Contraception is a pillar in reducing adolescent pregnancy rates. The American Academy of Pediatrics recommends that pediatricians develop a working knowledge of contraception to help adolescents reduce risks of and negative health consequences related to unintended pregnancy. Over the past 10 years, a number of new contraceptive methods have become available to adolescents, newer guidance has been issued on existing contraceptive methods, and the evidence base for contraception for special populations (adolescents who have disabilities, are obese, are recipients of solid organ transplants, or are HIV infected) has expanded. The Academy has addressed contraception since 1980, and this policy statement updates the 2007 statement on contraception and adolescents. It provides the pediatrician with a description and rationale for best practices in counseling and prescribing contraception for adolescents. It is supported by an accompanying technical report.

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“…2 Even though it has been announced by the U.S. Food and Drug Administration (FDA) as safe and effective since 1997, 4 ECP remains an underused method of pregnancy prevention. 5 To increase availability of ECP, prior studies have examined several dispensing options, including direct access through pharmacists, [6][7][8] provision of a prescription by providers in advance of need (i.e., advance provision), [9][10][11][12][13] and direct access to ECP without a prescription by making it available over-the-counter (OTC). 14,15 The studies provide evidence that these dispensing options are effective in increasing the use of ECP.…”

Section: Introduction Ementioning

confidence: 99%

Emergency Contraception Provision: A Survey of Michigan Physicians from Five Medical Specialties

Vahratian

Patel

et al. 2007

Journal of Women's Health

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Objective: Despite the controversy over expanding delivery options for emergency contraceptive pills (ECP), little is known about physicians' attitudes toward over-the-counter (OTC) provision of ECP, and prior research on physicians' practices often has focused on a single specialty. This study examined the attitudes and practices regarding advance provision and OTC status of ECP among physicians in five medical specialties likely to encounter patients in need of ECP.Methods: A mail survey of a random sample of 850 Michigan physicians in family/general medicine, internal medicine, obstetrics/gynecology, pediatrics, and emergency medicine was conducted. Respondents' ECP-related attitudes and practices were assessed, and differences by physician characteristics were examined using chi-square tests and multivariable logistic regression analyses.Results: Two hundred seventy-one physicians responded to the survey (response rate ‫؍‬ 32%), with 42% of them favoring OTC provision of ECP and 40% opposing it. Half of respondents never routinely initiated discussions about ECP with their sexually active, female patients, and 77% of respondents did not routinely offer advance prescriptions. After adjusting for other factors, including medical specialty, older physicians (Ն50 years) were significantly more likely than their younger counterparts to support OTC provision of ECP (OR ‫؍‬ 2.9, 95% CI 1.7-4.9) or offer advance prescriptions (OR ‫؍‬ 2.5, 95% CI 1.1-5.8). Physicians with a specialty in obstetrics/gynecology were 3.5 times (95% CI 1.3-9.8) as likely as physicians in family/general medicine to offer advance prescriptions for ECP, and female physicians were 2.5 (95% CI 1.05-6.0) times as likely as male physicians to offer advance prescriptions. Graduation from a medical school within the United States and practicing in a private practice were marginally associated with a lower likelihood of supporting OTC status of ECP (OR ‫؍‬ 0.5, 95% CI: 0.2-1.0; and OR ‫؍‬ 0.6, 95% CI 0.3-1.1, respectively).Conclusions: Certain physician characteristics were significantly associated with their ECPrelated attitudes and practices. The majority of physicians surveyed in this study did not offer advance prescriptions for ECP, and few had initiated discussions on ECP with patients, which may pose critical barriers to patients' timely access. 489

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Emergency contraception: randomized comparison of advance provision and information only

Abstract: Multiple emergency contraception doses supplied in advance did not tempt condom users to risk unprotected intercourse. After unprotected intercourse, however, those with pills on hand used them more often. Women found advance provision useful.

Cited by 90 publications

References 5 publications

Contraception for Adolescents

Contraception for Adolescents

Contraception for Adolescents

Emergency Contraception Provision: A Survey of Michigan Physicians from Five Medical Specialties

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