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Hormonal Contraceptives

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Overview

There are 61 million women of childbearing age (15–44) in the US. About 43 million of these women are at risk of unintended pregnancy; they are sexually active and do not want to become pregnant. About two-thirds of them use a contraceptive method correctly and consistently. Oral contraceptives have been in use for over 50 years and are one of the most popular contraceptives; this method is used by 26% of contraceptive users. Most oral contraceptives contain 2 hormones, an estrogen and a progestin (combined oral contraceptives; COCs). Progestin only pills (POPs) are also available. Certain other hormonal methods (vaginal ring, transdermal patch, injectables) are used by additional 7% of women.1 In the US, an increasing number of states allow pharmacists to provide contraceptives to women without a prescription; this will be the focus of this issue.

About 14% of women at risk of unintended pregnancy are not using contraception (or have long gaps of non-use) and another 18% use contraception but do so inconsistently. Among women using a contraceptive consistently, only 5% experience an unintended pregnancy. In contrast, about 85% of sexually active women who do not use contraception become pregnant within 1 year.

Healthy People 2020, a 2010 report from the US Department of Health and Human Services, provides science-based 10-year objectives for improving the health of all Americans.2 Family planning objectives include:

  • Increase the number of women at risk of unintended pregnancy who use contraceptives.
  • Reduce the proportion of women who experience pregnancy despite use of a reversible contraceptive method.
  • Reduce pregnancies among adolescent women aged 15-19 years.
  • Increase the percentage of women aged 15 to 44 years who adopt or continue use of effective methods of contraception.
These Healthy People 2020 family planning objectives can be addressed by pharmacists who provide counseling – and also by pharmacists in the states of California, Oregon, Tennessee, and Washington who prescribe hormonal contraceptives. Increased access to contraceptives may lower the number of unintended pregnancies. An additional benefit is a reduction in abortions.

Details

Publication Date: 01/22/2017
Expiration Date: 01/22/2020
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Leslie A. Shimp, Pharm.D., M.S. is a Professor Emerita of the College of Pharmacy at the University of Michigan, in Ann Arbor, MI.

Disclosure Statement

Dr. Shimp reports no financial relationship with the manufacturer(s) or provider(s)of any commercial product(s) or service(s) that appear in this issue.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Compare and contrast the methods of hormonal contraception provided in a pharmacy; review their pharmacology and relative effectiveness.
    2. Identify the most common side effects related to the estrogen and progestin components of hormonal contraceptives. Discuss the more serious risks associated with the use of estrogen-containing contraceptives.
    3. Counsel patients about their choice of hormonal contraceptive method, including the noncontraceptive benefits. Provide instructions to a woman who has missed one or more of her contraceptive doses.
    4. Apply the CDC Medical Eligibility Criteria to determine whether a woman is a candidate for hormonal contraceptives. Outline the CDC’s recommended steps that a clinician should follow when providing contraceptives.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-17-001-H01-P


Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator


Terry M. Baker, PharmD

Managing Editor


Tracy Farnen, PharmD

Associate Editors


James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor


Gerard Hatheway, PharmD, PhD

Editorial Advisors


Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners


Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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