Magazine article Drug Topics

Pharmacists Urged to Help Cut Unintended Pregnancies

Magazine article Drug Topics

Pharmacists Urged to Help Cut Unintended Pregnancies

Article excerpt

With more effective patient counseling, pharmacists could help reduce the number of unintended pregnancies in the United States by 20%. That's one implication of a new study by Michael Rosenberg, M.D., on the use and misuse of oral contraceptives. Rosenberg is president of Health Decisions Inc., a medical research firm in Chapel Hill, N.C., and clinical associate professor of obstetrics and gynecology at the University of North Carolina School of Medicine. The study was unveiled recently at the American College of Obstetrics & Gynecology annual meeting in San Francisco.

"The surprising finding from our analysis is that 687,000 unintended pregnancies per year are indirectly caused by side effects resulting from improper pill use," Rosenberg said. "These are not the stereotypical adolescents who aren't listening," he added. "The majority are adult women who are doing their best to avoid becoming pregnant."

About 18 million women in the United States today use oral contraceptives, with 3.7 million new users each year. Two-thirds, Rosenberg said, use them consistently and effectively; the other third do not and are at risk for side effects and unwanted pregnancy.

The biggest contributor to the failure of oral contraceptives, Rosenberg said, is lack of patient information. Half of all women leave their physician's office after a consult with unanswered questions on proper pill use, side effects, and other issues, he explained. Another 25% have additional question within the first month.

"This is an opportunity for the pharmacist to provide very concrete information," said Paul Lammers, M.D., director of medical services for Organon Inc. Organon markets Desogen (desogestrel/ethinyl estradiol) tablets in the United States. "There is an important role here for pharmacists in patient education."

The biggest single misuse of current oral contraceptive formulations, Rosenberg said, seems to be timing. The low-dose pills that most women use must be taken not just daily but at the same time every day for proper effect. Taking the pill at a different time each day by even a few hours reduces the contraceptive's effectiveness. Irregular dosing also intensifies side effects such as breakthrough bleeding.

Most women, Rosenberg said, find it easier to take the contraceptives as part of their morning ritual. …

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