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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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