Adolescents' and Young Adults' Ability to Self-Screen for Contraindications to Hormonal Contraception and the Role of Chronic Illness.
Adolescents' and Young Adults' Ability to Self-Screen for Contraindications to Hormonal Contraception and the Role of Chronic Illness.
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DOI：
10.1016/j.jadohealth.2021.04.032
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发表时间：
2021-10
影响因子：
7.6
通讯作者：
Ott, Mary A.
中科院分区：
文献类型：
--
作者：
Wilkinson, Tracey A.;Meredith, Ashley H.;Rafie, Sally;Katz, Amy J.;Vielott, Thomas L.;Meagher, Carolyn G.;Ott, Mary A.
关键词：
多个州允许药剂师开出荷尔蒙避孕药，但可以有年龄限制。这项研究的目的是检查年龄如何影响青少年和年轻人(Aya)自我报告激素避孕的潜在禁忌症的能力，并与医生报告(我们的“黄金标准”)进行比较。2017年2月至2018年8月，在门诊青少年初级和专科护理诊所招募了14-21岁的妇女和她们的医生。根据疾病控制中心医学资格标准的定义，对于激素避孕的潜在禁忌症的医疗条件，单独完成筛查。总体不一致被定义为患者和提供者的回答之间的差异；潜在的不安全不一致被定义为AYAS对禁忌症的报告不足。用多变量Logistic回归检验总体不一致性和不安全不一致性的预测因素。在394对Aya/医生组合中，45%来自专科诊所，35%被确认为非裔美国人，平均年龄为16.7±1.9岁，38%为性行为活跃。50%的患者报告了激素避孕的潜在禁忌症。不安全不一致的发生率只有18%，年龄没有统计学差异，但专科专科诊所的不安全不一致性比率更高(28%比10%)。在普通或专科诊所中，没有变量可以预测较高的不安全不一致性比率。AYAS和医生关于联合激素避孕的医学禁忌症的报告之间潜在的总体和不安全的不一致与较年轻的年龄无关，因此支持扩大青少年获得药物的机会。儿科专科医生需要积极主动地解决荷尔蒙避孕的需求和安全性，因为药房的使用范围扩大了。
Multiple states allow pharmacists to prescribe hormonal contraception but can have age restrictions. The study objective was to examine how age influences adolescents’ and young adults’ (AYA) ability to self-report potential contraindications to hormonal contraception compared with physician reports (our “gold standard”). Between February 2017-August 2018, women 14–21 years old and their physicians were recruited in outpatient adolescent primary and subspecialty care clinics. Screeners were completed separately for medical conditions that are potential contraindications to hormonal contraception as defined by the Centers for Disease Control Medical Eligibility Criteria. Overall discordance was defined as differences between the patient’s and provider’s answers; potential unsafe discordance was defined as AYAs under-reporting of contraindications. Multivariable logistic regression was used to examine predictors of overall and unsafe discordance. Of 394 AYA/physician pairs, 45% were from subspecialty clinics, 35% identified as African American, mean age was 16.7 ± 1.9 years, and 38% were sexually active. Fifty percent of patients reported potential contraindications to hormonal contraception. There was only an 18% rate of unsafe discordance, with no statistical difference by age but a higher rate in subspecialty clinics (28% vs. 10%). No variables were predictive of higher rates of unsafe discordance in general or subspecialty clinics. Potential overall and unsafe discordance between AYAs’ and physicians’ reports of medical contraindications to combined hormonal contraception were not related to younger age and thus support expansion of pharmacy access to adolescents. Pediatric subspecialists need to proactively address hormonal contraceptive needs and safety as pharmacy access expands.
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影响因子：
7.6
作者：
Sedgh, Gilda;Finer, Lawrence B.;Singh, Susheela
通讯作者：
Singh, Susheela
影响因子：
33.7
作者：
Curtis, Kathryn M.;Tepper, Naomi K.;Whiteman, Maura K.
通讯作者：
Whiteman, Maura K.
影响因子：
2.7
作者：
Hein IM;De Vries MC;Troost PW;Meynen G;Van Goudoever JB;Lindauer RJ
通讯作者：
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影响因子：
8
作者：
Britto, MT;DeVellis, RF;Slap, GB
通讯作者：
Slap, GB
影响因子：
3.1
作者：
Boyce, William;Torsheim, Torbjorn;Zambon, Alessio
通讯作者：
Zambon, Alessio