scholarly journals Pharmacy Implementation of a New Law Allowing Year-Long Hormonal Contraception Supplies

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 165
Author(s):  
Gelareh Nikpour ◽  
Antoinette Allen ◽  
Sally Rafie ◽  
Myung Sim ◽  
Radhika Rible ◽  
...  
Keyword(s):  
Insurance Coverage ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Awareness Campaign ◽  
Insurance Reimbursement ◽  
Unplanned Pregnancies ◽  
It Compliance ◽  
Publicly Insured ◽  
Insured Patients ◽  
Selection Of

Background: Prescription hormonal contraceptive methods are vital to prevention of unplanned pregnancies. New legislation among 23 states has expanded access to contraception. In California, a 2017 law requires pharmacists to dispense year-long supplies of contraception and insurance plans to cover it upon patients’ request. This study assesses pharmacist knowledge of this new law 6 months after enactment. Methods: From July to November 2017, a random selection of 600 community pharmacies were called requesting a pharmacist (n = 532, 88.7% response). Pharmacists were asked if they had heard of the new law, if they would dispense a year-long supply to cash-pay, privately or publicly insured patients, and what they perceived as obstacles to dispensing year-long supplies. Results: Awareness of this law was assessed through these surveys. Most pharmacists responded they would dispense year-long supplies to cash-pay patients, regardless of knowledge of the new law (81% of “knew”, 70% of “did not know”, p = 0.1046). The top two perceived obstacles were insurance reimbursement (55.8%) and store policy (13.4%). Conclusion: Despite a new law requiring insurance coverage of a year-long supply of prescription birth control, most pharmacists were unaware at six months after the policy went into effect. Of those who were aware, the majority did not clearly understand it. Compliance among insurance plans is unknown. There was no implementation plan or awareness campaign for the new law.

Individual choice of hormonal contraceptive

2019 ◽  
Vol 1 (1) ◽  
pp. 6-14
Author(s):  
I. V. Kuznetsova
Keyword(s):  
Unwanted Pregnancy ◽  
Hormonal Contraception ◽  
Health Benefits ◽  
Hormonal Contraceptive ◽  
Therapeutic Effects ◽  
Individual Choice ◽  
Individual Selection ◽  
The Individual ◽  
Selection Of

Contraception is a unique tool that helps not only to avoid unwanted pregnancy and its termination, but also to get additional health benefits. However, the prevalence of the use of contraceptives as a whole and the resource itself, in terms of additional benefits, hormonal contraception, is far from the actual needs. The presented review substantiates the algorithm for the individual selection of a hormonal drug depending on the clinical portrait of a woman in order to solve the problem of reliable and safe protection from pregnancy with preventive and therapeutic effects.

scholarly journals Clinical features of migraine with onset prior to or during start of combined hormonal contraception: a prospective cohort study

2021 ◽  
Author(s):  
Gabriele S. Merki-Feld ◽  
Peter S. Sandor ◽  
Rossella E. Nappi ◽  
Heiko Pohl ◽  
Christoph Schankin
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Natural Cycle ◽  
Free Interval ◽  
Migraine Frequency ◽  
Combined Hormonal Contraception ◽  
Migraine Onset

AbstractMany studies have described the features of menstrually related migraines but there is a lack of knowledge regarding the features of migraine in combined hormonal contraceptive users (CHC). Hormone-withdrawal migraines in the pill-free period could differ from those in the natural cycle. Gynaecologic comorbidities, like dysmenorrhea and endometriosis, but also depression or a family history might modify the course of migraine. A better understanding of migraine features linked to special hormonal situations could improve treatment. For this prospective cohort study, we conducted telephone interviews with women using a CHC and reporting withdrawal migraine to collect information on migraine frequency, intensity, triggers, symptoms, pain medication, gynaecologic history and comorbidities (n = 48). A subset of women agreed to also document their migraines in prospective diaries. The mean number of migraine days per cycle was 4.2 (± 2.7). Around 50% of these migraines occurred during the hormone-free interval. Migraine frequency was significantly higher in women who suffered from migraine before CHC start (5.0 ± 3.1) (n = 22) in comparison to those with migraine onset after CHC start (3.5 ± 2.1) (n = 26). Menstrually related attacks were described as more painful (57.5%), especially in women with migraine onset before CHC use (72%) (p < 0.02). Comorbidities were rare, except dysmenorrhea. The majority of migraine attacks in CHC users occur during the hormone-free interval. Similar as in the natural cycle, hormone-withdrawal migraines in CHC users are very intense and the response to acute medication is less good, especially in those women, who developed migraine before CHC use.

Estetrol and the possibilities of its clinical use

2021 ◽  
Vol 86 (3) ◽  
pp. 217-221
Author(s):  
Petr Křepelka ◽  
Keyword(s):  
Ethinyl Estradiol ◽  
Fetal Liver ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Cardiovascular Complications ◽  
Estradiol Valerate ◽  
Planned Parenthood ◽  
Menopausal Syndrome ◽  
Contraceptive Effectiveness ◽  
Combined Hormonal Contraception

Summary Combined hormonal contraceptive methods are one of the most commonly used methods of planned parenthood. They show high contraceptive effectiveness, reasonable cycle control and bring several non-contraceptive benefits. A limitation of the widespread use of combined hormonal contraception is the risk of cardiovascular complications in individuals with specific risk factors. The risk of cardiovascular complications is related to the used estrogen component. Currently, the most common use of estrogen in combined hormonal contraception is ethinyl estradiol and estradiol valerate. The good estrogenic part of combined oral contraceptives is estetrol, a hormone produced exclusively by the fetal liver. Estetrol exhibits a tissue-selective receptor activity. Unlike previously used estrogens, it does not negatively affect the production of liver proteins and blood clotting parameters. Estetrol is not a perspective for combined hormonal contraception only. It is also promising for treating and preventing osteoporosis, hormonal therapy of menopausal syndrome, and vulvovaginal atrophy syndrome.

scholarly journals Market Diffusion of Extended Cycle Hormonal Contraceptives

2012 ◽  
Vol 3 (3) ◽  
Author(s):  
Megen Leeds Schumacher ◽  
Ashley Cetola Pettia ◽  
Albert I Wertheimer
Keyword(s):  
Hormonal Contraception ◽  
Target Population ◽  
Hormonal Contraceptive ◽  
The United States ◽  
Hormonal Contraceptives ◽  
Original Research ◽  
Main Concern ◽  
Novel Approach ◽  
Market Diffusion ◽  
Extended Cycle

Background: Extended cycle hormonal contraceptives (e.g. Seasonale, Seasonique) when introduced in 2003 were considered a very novel approach to contraception. The idea of manipulating the menstrual cycle so that women would experience just four menstruations a year was radical and was assumed to be responsible for the slow acceptance rate among the general public. Objective: This report analyzes two different aspects of the acceptance of this unique idea in the population. The first was the level of usage of extended cycle hormonal contraceptives in the general population, which was measured by a review of sales figures over time in the United States. The second was an examination of market diffusion as it relates to consumer perceptions regarding the characteristics of these products. Methods: To determine the degree of usage of extended cycle hormonal contraceptives the yearly sales, in terms of units sold, were compared with that of other leading methods of hormonal contraception. Along with the data, survey answers were obtained from 65 women who volunteered to participate in the study. Participants were selected randomly to represent the target population to assess the level of awareness about the benefits, risks, and any other concerns regarding the use of extended cycle hormonal contraceptives. Results: The yearly sales data of units sold showed a definitive increase in the sales of extended cycle hormonal contraceptives since their release on the market. The survey results showed an overwhelming awareness in the study population about the extended regimen. However, only about half of the women in the survey group were aware of its benefits. The main concern reported was the perceived significant side effect profile. Conclusion: Though awareness about the extended cycle hormonal contraception regimen was widespread, the survey population was not well informed about the advantages and the disadvantages regarding the degree of severity of side effects. To address these knowledge deficits, these aspects should be the focus when distributing information about extended cycle hormonal contraceptive regimens. This may boost the use of a potentially advantageous contraceptive regimen by a population who would derive benefit from its usage.   Type: Original Research

scholarly journals Development of the Regulation of Insurance Intermediaries in the Czech Republic

2019 ◽  
pp. 343-352
Author(s):  
Martina Krügerová
Keyword(s):  
Czech Republic ◽  
Insurance Coverage ◽  
Distribution Channels ◽  
Legal Regulation ◽  
Main Channel ◽  
Insurance Market ◽  
The Czech Republic ◽  
Registered Intermediaries ◽  
Selection Of

In the insurance market, various distribution channels can be selected to distribute an insurance coverage. The selection of those channels depend on many factors and specific criteria. The insurance intermediaries represent the main channel for external distribution channels (also called the intermediary channel). The aim of this article is to summarise the legal regulation of insurance intermediaries and to show changes in the development of registered intermediaries.

scholarly journals Risk Factors of Body Mass Index (BMI), Age of Menarche, Parity and Hormonal Contraception of Genu Osteoarthritis in Female Patients

2021 ◽  
Vol 57 (2) ◽  
pp. 104
Author(s):  
Alisiya Alisiya ◽  
Sulistiawati Sulistiawati ◽  
Patricia Maria Kurniawati ◽  
RR Indrayuni Lukitra Wardhani
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Hormonal Contraceptives ◽  
Control Group ◽  
Case Group ◽  
Control Approach ◽  
Female Patients ◽  
Age Of Menarche

Osteoarthritis (OA) is a degenerative disease related to joint cartilage and commonly occurs in the knee joint. The 2013 National Survey recorded the prevalence of joint diseases in East Java was 26.9%. OA affected more women than men due to the estrogen and caused disabilities in many women. This study aimed to find the relationship between Body Mass Index (BMI), age of menarche, parity, and the use of hormonal contraceptives against OA in genu at Universitas Airlangga Hospital, Surabaya. This was an analytic observational study with a case-control approach. Data collection was carried out through a short interview using a questionnaire. The sample size was calculated using a formula and found that the study required 42 patients with OA in the case group and 42 patients without OA in the control group. The case group was dominated by patients with 56-60 years old age (62.1%), BMI 23-24.9 kg/m2 (58.7%), menarche age 12-13 years (53.6%), multiparous (52.6%), having contraception pill usage history (62.3%) particularly using combination pills (60.5%) with a mean duration of use > 1 year (56.8%). There was a relationship between BMI and type of hormonal contraceptive used against genu OA in female patients at Universitas Airlangga Hospital Surabaya.

scholarly journals Férfi hormonális fogamzásgátlás: múlt, jelen, jövő

2017 ◽  
Vol 158 (46) ◽  
pp. 1819-1830 ◽  
Author(s):  
Norbert Pásztor ◽  
Borbála Eszter Hegyi ◽  
Attila Badó ◽  
Gábor Németh
Keyword(s):  
Follicle Stimulating Hormone ◽  
Hormone Secretion ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Contraceptive Methods ◽  
Luteinizing Hormone Secretion ◽  
The World ◽  
Effective Contraception ◽  
In The Beginning ◽  
Contraceptive Agent

Abstract: In certain regions of the world the enormous rate of population growth raises economic and public health concerns and widely accessible contraceptive methods would be desired. In contrast, in other countries the use of effective contraception is a question of individual preferences. Today, most of the reliable contraceptive methods are applied by women, while the options for male methods are quite limited. It is well known that significant portion of pregnancies are still unplanned and several data revealed men’s willingness to take part in family planning. Based on these needs, remarkable efforts have been made to develop a suitable hormonal contraceptive agent for men. With the exogenous suppression of follicle stimulating hormone and luteinizing hormone secretion, the inhibition of the testicular testosterone production and the spermatogenesis can be achieved. In the beginning, testosterone-derivatives, or testosterone-progestin combinations were administered, later synthetic androgen agents were developed. Despite of these efforts, unfortunately, there is no safe, widely feasible male hormonal contraception to date, but in the future this goal can be achieved by solving the key hurdles. Orv Hetil. 2017; 158(46): 1819–1830.

Change in facility-level share of Medicaid patients with cancer following implementation of the affordable care act.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18543-e18543
Author(s):  
Matthew Buck ◽  
Patrick C Demkowicz ◽  
James Nie ◽  
Victoria A. Marks ◽  
Michelle C. Salazar ◽  
...  
Keyword(s):  
Affordable Care Act ◽  
Insurance Coverage ◽  
Study Endpoint ◽  
Primary Study ◽  
Factors Associated ◽  
Percentage Points ◽  
The Affordable Care Act ◽  
Facility Level ◽  
Insured Patients ◽  
Medicaid Expansions

e18543 Background: Although Medicaid expansions associated with the Affordable Care Act (ACA) significantly increased insurance coverage for Americans with cancer, there is evidence that some facilities limit the number of Medicaid patients they treat due to lower reimbursement. We aimed to assess facility-level changes in the proportion of patients with Medicaid who were diagnosed with cancer in relation to Medicaid expansions associated with the ACA. Methods: We identified adult patients with the 19 most commonly diagnosed cancers using the National Cancer Database who were diagnosed with cancer from 2010 through 2017. We clustered Commission on Cancer (CoC) accredited institutions and included those diagnosing at least 10 patients in each year. The primary study endpoint was the change in the proportion of Medicaid-insured individuals relative to the implementation of the ACA (pre- and post-Jan 1, 2014). We used adjusted difference-in-differences (DID) estimation and multivariable logistic regression to examine patient and facility-level factors associated with changes in the proportion of Medicaid insured individuals. Results: We identified 1,064 eligible facilities in the study period. There were considerable changes in the share of Medicaid insured patients at the facility-level (range -20.0% to +44.7%, IQR -0.64% to +5.63%). There were significantly larger changes in facilities located in Medicaid expansion states (11.5 to 16.5% percentage points) versus non-expansion states (9.2 to 8.9% percentage points) with adjusted DID +5.79% (p < 0.001). Despite overall increases, 14.6% of facilities in expansion states experienced reductions in their share of Medicaid insured patients. Facility factors associated with decreasing share of Medicaid patients were non-expansion status (OR: 6.25, 95% CI 3.89 – 9.98, p < 0.001) and higher baseline Medicaid population (OR: 2.93, 95% CI 2.00 – 4.35, p < 0.001). There was also significant regional variation with larger decreases in the West South Central (OR: 5.86, 95% CI 2.30 – 15.74, p < 0.001) and West North Central (OR: 2.46, 95% CI 1.07 – 5.87, p = 0.037) regions. Conclusions: Although state expansions associated with the ACA led to increases in the share of Medicaid-insured patients diagnosed with cancer at CoC facilities, there was considerable variation in changes at the facility-level. These findings highlight that improved insurance coverage may not be sufficient to improve access to care, and facility-level policies may remain a source of access disparity.

scholarly journals Hormonal contraception and HIV acquisition among women: an updated systematic review

2020 ◽  
Vol 46 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Kathryn M Curtis ◽  
Philip C Hannaford ◽  
Maria Isabel Rodriguez ◽  
Tsungai Chipato ◽  
Petrus S Steyn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Study ◽  
Oral Contraceptives ◽  
Hiv Risk ◽  
Contraceptive Method ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Contraception Use ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition

ObjectiveTo update a 2016 systematic review on hormonal contraception use and HIV acquisition.MethodsWe searched Pubmed and Embase between 15 January 2016 and 26 June 2019 for longitudinal studies comparing incident HIV infection among women using a hormonal contraceptive method and either non-users or users of another specific hormonal contraceptive method. We extracted information from newly identified studies, assessed study quality, and updated forest plots and meta-analyses.ResultsIn addition to 31 previously included studies, five more were identified; three provided higher quality evidence. A randomised clinical trial (RCT) found no statistically significant differences in HIV risk among users of intramuscular depot medroxyprogesterone acetate (DMPA-IM), levonorgestrel implant (LNG implant) or the copper intrauterine device (Cu-IUD). An observational study found no statistically significant differences in HIV risk among women using DMPA, norethisterone enanthate (NET-EN), implants (type not specified) or Cu-IUD. Updated results from a previously included observational study continued to find a statistically significant increased HIV risk with oral contraceptives and DMPA compared with no contraceptive use, and found no association between LNG implant and HIV risk.ConclusionsHigh-quality RCT data comparing use of DMPA, LNG implant and Cu-IUD does not support previous concerns from observational studies that DMPA-IM use increases the risk of HIV acquisition. Use of other hormonal contraceptive methods (oral contraceptives, NET-EN and implants) is not associated with an increased risk of HIV acquisition.

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