Nonprescription Availability of Emergency Contraception in the United States: Current Status, Controversies, and Impact on Emergency Medicine Practice

Ranney, Megan L.; Gee, Erin M.; Merchant, Roland C.

doi:10.1016/j.annemergmed.2005.07.001

Cited by 10 publications

(6 citation statements)

References 82 publications

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“…Similar to other surveys, 28 we observed divided attitudes among physicians about OTC provision of ECP even though a number of health professional organizations, including the American Medical Association, the American Public Health Association, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, the American College of Emergency Physicians, and at least 60 other organizations, support increasing access through this route. 3,[32][33][34] Fortytwo percent of survey respondents favored OTC provision of ECP, whereas 40% opposed it.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] ECP can be effective if taken up to 120 hours after unprotected intercourse or contraceptive failure; however, its efficacy decreases with prolonged time to initiation. 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.…”

Section: Introduction Ementioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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“…2,4 OECs are widely available in several other countries without a pre-scription, and direct provision by pharmacists is permitted in many other countries. 2,7 Plan B (levonorgestrel-Duramed, Barr Pharmaceuticals) is an OEC product that has been sold as a prescription drug since receiving Food and Drug Administration (FDA) approval in 1999. 8 In August 2006, FDA approved Plan B, also known as the "morning-after pill," to be sold without a prescription to women aged 18 years or older, but a prescription is still required for women younger than 18 years.…”

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confidence: 99%

Student pharmacist knowledge and attitudes regarding oral emergency contraception

Evans

Patel

Stranton

2007

Journal of the American Pharmacists Association

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“…Ethically, such providers may, however, have an ethical obligation to foresee this impasse coming about and do then whatever they can to prevent the patient from suffering due to their hidden, possibly even idiosyncratic moral view. 32 Providers in any case may at least have an affirmative obligation to inform patients who could be significantly affected by their outlying moral view that they have this view as early on as possible. Then, they can seek out on their own another provider if they want to.…”

Section: Providers' Moral Conscience (When If Ever Should Providers N...mentioning

confidence: 99%

Current ethical dilemmas in obstetrical practice and some suggestions regarding how to resolve them

Howe¹

2023

IPCB

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As new ethical conundrums arise in obstetrics, providers are ever-increasingly challenged with having to know the best means of resolving these problems since Roe v. Wade was overturned. New ethical challenges have arisen, for example, as to how clinicians should respond when patients would need to travel to another state to get an abortion. A second illustrative example involves minors. In some states in the U.S., these patients legally can request permission from a judge to have an abortion without their having to tell their parents. If these adolescents don’t know this, providers must decide whether they should take initiative to inform them of this possibility and if so, when. This question is still more challenging when these patients, too, live in a state that does not allow them the option of abortion. Providers confronted with ethical problems such as those above may struggle to determine how to best resolve these dilemmas. This piece will review some key and especially more subtle, ethical approaches that providers may face to better resolve them. Initially, I will highlight approaches to resolving ethical outcomes that providers may not know or may overlook. These will include how providers may best apply both core ethical principles and an additional, adjunctive framework, known as the care perspective or ethics of care. I will provide specific examples to illustrate each

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Nonprescription Availability of Emergency Contraception in the United States: Current Status, Controversies, and Impact on Emergency Medicine Practice

Cited by 10 publications

References 82 publications

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

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

Student pharmacist knowledge and attitudes regarding oral emergency contraception

Current ethical dilemmas in obstetrical practice and some suggestions regarding how to resolve them

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