ORAL CONTRACEPTION (OC) - OVER THE COUNTER (OTC)? - PowerPoint PPT Presentation

Loading...

PPT – ORAL CONTRACEPTION (OC) - OVER THE COUNTER (OTC)? PowerPoint presentation | free to download - id: 76ae8d-ZWQ0M



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

ORAL CONTRACEPTION (OC) - OVER THE COUNTER (OTC)?

Description:

Title: No Slide Title Author: SHAINA HENIGMAN Last modified by: Orga-Med Created Date: 9/2/2001 6:07:01 PM Document presentation format: 35mm Slides – PowerPoint PPT presentation

Number of Views:170
Avg rating:3.0/5.0
Slides: 29
Provided by: SHAI45
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: ORAL CONTRACEPTION (OC) - OVER THE COUNTER (OTC)?


1
ORAL CONTRACEPTION (OC) - OVER THE COUNTER (OTC)?
Arie Yeshaya, M.D. Pediatric Adolescent
Clinic Schneider Childrens Hospital and Departmen
t of Obstetrics and Gynecology Rabin Medical
Center, Petah Tikva, Israel
2
OC - OTC ?
  • The pill off prescription? (Lester,
    1974)
  • The pill without prescription (Winaver, 1975)
  • OC without prescription (Houghton, 1993)
  • Making OC available over the counter
    (Youngkin et al. 1996)

3
POSTCOITAL EMERGENCY CONTRACEPTION (Yuzpe,
1974)
4
Should Oral Contraceptives Be Sold Over
the-Counter?
  • A prescription drug should be switched to
  • over the counter Status if
  • The drug is safe for self medication
  • The drug is effective when self administered
  • The condition to be treated is self diagnosable
  • The drugs labeling is tailored to self
  • administration

5
OC - OTC PROS
6
OC - OTC
  • Easier to achieve
  • More users
  • Less unwanted pregnancies Less abortions
  • Lower maternal morbidity and mortality

7
WORLDWIDE STATISTICS
  • gt1 of 2 pregnancies are unwanted
  • Induced abortions gt50x106/year
  • Maternal mortality - 600,000/year

8
GYNECOLOGICAL EXAMINATION - INCONVENIENT
EXPERIENCE
9
DR. OC-OTC
  • On vacation until ..

10
NON-CONTRACEPTIVE BENEFITS OF OC
  • Reduction in
  • Ovarian cancer
  • Endometrial cancer
  • PID
  • Ectopic pregnancy
  • Anemia
  • Dysmenorrhea
  • Functional ovarian cysts
  • Benign breast disease
  • Acne
  • Hirsutism
  • Irregular menses
  • Menorrhagia

11
  • Various OC - no differences
  • Deleterious effect - minimal/reversible
  • Follow-up - limited

12
SEVERE COMPLICATIONS WITH OC ARE RARE
  • Venous thrombosis - 6/10,000
  • (Without OC - 3/10,000)
  • Unavoidable

13
THE ROLE OF THE PHYSICIAN
  • Expensive
  • Sex is not a disease

14
OC - OTC CONS
  • Counseling for reproduction and sexual health
  • Avoidance of counseling for family planning,
    reproduction and sexual health

15
OC - OTC CONS
  • No counseling - Higher dropout

16
OC CONTRAINDICATIONS
  • Thrombophlebitis
  • Breast cancer
  • Cervical, endometrial and ovarian cancer
  • Focal migraine
  • Smokers gt35 years of age

17
OC - DIFFERENT EFFECTS
  • Estrogens
  • Progesterones
  • Androgens

18
  • Gynecological counseling
  • Gynecological examination can be avoided,
    especially in adolescents

19
OC FOLLOW-UP IMPORTANCE
  • Over 35 years of age
  • Smokers
  • Hypertension
  • Diabetes
  • Hyperlipidemia

20
  • ATTITUDE OF FEMALE COLLEGE STUDENTS TOWARDS
    AVAILABILITY OF OC OTC
  • Forman et al. (1997)

21
  • No. - 290
  • Age - 20 3
  • 84 - previous sexual intercourse
  • Age at first sexual encounter - 16.6 2
  • 52 used OC at first encounter

22
  • 65 - against OC-OTC
  • Side effects could be prevented
  • Users would not go for regular checkups
  • 35 - pro OC-OTC
  • Fewer unwanted pregnancies

23
OC - OTC PROS and CONS
  • Not significant
  • Race
  • Previous OC use
  • Previous sexual activity
  • Significant
  • A previous pregnancy (Pro)

24
Should Oral Contraceptives Be Sold Over
the-Counter?
  • Potential Advantages
  • Increased access to affective birth control for
    all women
  • Increased access for younger women, the prime
    users of OCs
  • Reduced rate of unintended pregnancies
  • Cost savings from reduction of physician and
    family planning clinic visits
  • Encouragement of the national trend toward
    self-care
  • Potential Disadvantages
  • Increased rate of unintended pregnancies due to
    unproper use of OCs
  • Reduced OC compliance because of lack of
    counseling and management of nuisance side
    effects
  • Increase in liability due to errors in
    self-prescribing
  • Possible cost increases for Medicaid and family
    planning clinic patients
  • Possible price increases due to the costs of
    marketing to consumers
  • Reduced opportunities for preventive medical care

25
OC - OTC
  • Population, social and religious attitude
  • Availability of local family planning service
  • Availability of providers

26
Conclusion
  • In order to expand OCs use
  • Reinforce the activity of family planning
    Clinics
  • Facilitate public access to professionals
  • Instituting charge free visits
  • Organizing visits to schools

27
Conclusion
Better access to physicians might be the best way
to Establish the OC as the main and most
efficacious Contraceptive method
28
So.should it be prescribed, or OTC?
THE END
About PowerShow.com