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					                    A comparative analysis of regulated vs. deregulated emergency contraception
                                                       Alicia Nguyen, PA-S and Patricia Bunton, MS, PA-C
                                                                Department of Physician Assistant
                                                        College of Health Professions, Wichita State University



               INTRODUCTION                                                RESULTS                                                DISCUSSION
The United States holds the highest rate for
                                                   • Eight of 12 studies showed that most                         This evidence-based review supports
unplanned teen pregnancies among all
developed countries in the world. It is apparent   patients used EC correctly and had a good                      findings of other studies. It is interesting to
that abstinence and the utilization of             understanding of the mechanism of                              note that although AEC allowed for earlier
contraceptives are vital in the reduction of                                                                      and more timely access to EC, those who
                                                   action, the therapeutic uses and/or its
these numbers.       Among all methods of                                                                         had AEC were not using it when it was
                                                   adverse effects.
contraception, accessibility to emergency                                                                         indicated because they did not believe they
contraception (EC) has been problematic, as                                                                       were at an increased risk of pregnancy.
                                                   • Four studies indicated pregnancy rates                       Future comparison studies of the risks and
has education regarding its proper utilization.
Central arguments that have prevented              in treatment groups were higher than                           benefits of EC need to include OTC and
deregulation of EC include concern that            expected. Despite improved access and                          pharmacy access, as well as AEC, to
improved access would compromise routine           an increase in EC usage, EC is still                           evaluate patient behavior when there are
contraceptive use and increase the incidence       underused.                                                     various deregulated routes of EC access.
of risky behavior and/or sexually transmitted
diseases. Methods that would constitute as         • One study showed that increased
deregulation or increased access of EC would       access to EC negatively affected the use                                     CONCLUSIONS
include direct supply by pharmacies or
                                                   of routine contraception.
emergency departments, advanced provision                                                                         This review found       no evidence to
of emergency contraception (AEC) by health                                                                        indicate that regulated access to EC is
professionals and dispensing of EC over-the-       •Two studies showed that, although AEC                         more advantageous than deregulated.
counter (OTC).                                     led to a higher likelihood of timely use                       Deregulation and increased accessibility
                 METHODS                           compared to obtaining EC through clinic                        to EC leads to increased usage, promotes
This was an evidenced-based medicine
                                                   access, those who received AEC had                             timely access, does not compromise
literature review using         Medline and        higher rates of unprotected sex. Other                         routine use of contraceptives and is safe
included articles from 1998 to the present.        studies have indicated that risky behavior                     enough to be dispensed OTC or in
Peer-reviewed articles were chosen based           is not associated with increased EC                            advanced provisions. Of all deregulated
on the requirement that each article was to        availability.                                                  methods of EC, AEC proves to be the
be retrospective, a randomized controlled                                                                         best route to EC access. Women need to
trial, cohort, actual use study or a literature                                                                   be educated on reproduction and fertility
review. The following key terms were used:                                                                        risks so they understand the need and
emergency contraception, EC, Plan B,                                                                              importance of EC availability and usage.
levonorgestrel, advanced provision, OTC,
over-the-counter, deregulation, regulation,
prescription. Twenty-six articles met the
criteria.

				
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posted:12/23/2010
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