Abstract:
OBJECTIVE:To estimate unintended pregnancies averted and the cost effectiveness of pharmacist prescription of hormonal contraception. METHODS:A decision-analytic model was developed to determine the cost effectiveness of expanding the scope of pharmacists to prescribe hormonal contraception compared with the standard of care and contraceptive access in clinics. Our perspective was that of the payor, Oregon Medicaid. Our primary outcome was unintended pregnancies averted. Secondary outcomes included: costs and quality-adjusted life years (QALYs). Model inputs were obtained from an analysis of Medicaid claims for the first 24 months after policy implementation in Oregon, and the literature. Univariate and bivariate sensitivity analyses, as well as a Monte Carlo simulation, were performed. RESULTS:Among Oregon's Medicaid population at risk for unintended pregnancy, the policy expanding the scope of pharmacists to prescribe hormonal contraception averted an estimated 51 unintended pregnancies and saved $1.6 million dollars. Quality of life was also improved, with 158 QALYs gained per 198,000 women. Sensitivity analysis demonstrated that the model was most sensitive to the effect on contraceptive continuation rates. If contraceptive continuation rates among women receiving care from a pharmacist are 10% less than among clinicians, than pharmacist prescription of hormonal contraception will not avert unintended pregnancies. CONCLUSION:Pharmacist prescription of hormonal contraception averts unintended pregnancies and is cost effective. Full implementation of the policy is needed for maximum benefits. Prospective data on the effect of the policy on contraceptive continuation rates are needed.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Rodriguez MI,Hersh A,Anderson LB,Hartung DM,Edelman ABdoi
10.1097/AOG.0000000000003265subject
Has Abstractpub_date
2019-06-01 00:00:00pages
1238-1246issue
6eissn
0029-7844issn
1873-233Xpii
00006250-201906000-00023journal_volume
133pub_type
杂志文章abstract:OBJECTIVE:To measure the serum levels of interleukin (IL)-8, prostaglandin (PG) F2alpha, and beta-endorphin in parturients with acupuncture treatment and in controls to clarify the effect of acupuncture and duration of labor on the serum levels of substances active in cervical ripening and dilatation. METHODS:A matche...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/s0029-7844(98)00200-2
更新日期:1998-08-01 00:00:00
abstract::The authors attempted to relate neonatal mortality to method of delivery in a series of 345 infants, weighing 700 to 1500 g, who were born in King County, Washington, from 1977 to 1979. Overall, 38% of infants delivered vaginally died as opposed to 32% of those with cesarean births. However, after adjustment for birth...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract::Transvaginal sonographic localization of the placenta was performed in 100 patients suspected of having placenta previa. Except in one patient, the diagnosis was confirmed at cesarean delivery in all cases of placenta previa found by sonography before delivery, resulting in a 93.3% predictive value of a positive test....
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199011000-00006
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To calculate pooled risk estimates for combinations of cytology result, human papillomavirus (HPV) 16/18 genotype and colposcopy impression to provide a basis for risk-stratified colposcopy and biopsy practice. DATA SOURCE:A PubMed search was conducted on June 1, 2016, and a ClinicalTrials.gov search was con...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1097/AOG.0000000000002812
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the Interstitial Cystitis Symptom Index and Problem Index as a screening tool for interstitial cystitis, and to estimate the prevalence and risk factors for interstitial cystitis in women with chronic pelvic pain. METHODS:Forty-five women scheduled to undergo laparoscopy for chronic pelvic pain w...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02087-2
更新日期:2002-08-01 00:00:00
abstract::It has long been recognized that fatigue can affect human cognitive and physical function. Although there are limited published data on the effects of fatigue on health care providers, including full-time practicing physicians, there is increasing awareness within the patient safety movement that fatigue, even partial...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181666025
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To find out if hepatocyte growth factor (HGF) in amniotic fluid (HGF-AF) has a direct effect on fetal lung development, we investigated the effects of AF as well as recombinant human HGF (rhHGF) on proliferation, migration, and morphogenesis of fetal alveolar type II cells in vitro. METHODS:Amniotic fluid sa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00083-5
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:Despite a change of fetal physiologic and biochemical functions with gestational age, stationary umbilical cord acid-base reference values are used as measures of obstetric care quality. The aim of this study was to assess the risk of low Apgar score relative to low pH when using stationary versus gestational...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(03)00512-x
更新日期:2003-08-01 00:00:00
abstract::To examine the validity of cervical cytologic diagnosis of sexually transmitted diseases, we reviewed the literature and calculated the efficacy of the Papanicolaou smear as a diagnostic technique. The predictive value of a positive test varied widely, but was generally higher for Trichomonas vaginalis (0.81-1.00) tha...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:To evaluate a possible correlation between a new variable-persistent breech presentation-and the success rate of external cephalic version (ECV). METHODS:This was a retrospective study of ECVs performed from January 2008 through January 2019 in an Israeli tertiary care hospital. The study group included all ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000004231
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Malignant transformation of endometriosis in an episiotomy site is rare. CASE:A 42-year-old woman presented with a palpable mass, 2.5 cm in size, just inside the posterior commissure of the vagina, at the site of a previous episiotomy for a vaginal delivery. Three years previously, an endometriotic cyst had...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318179475b
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:To estimate the rate of early-onset group B streptococcal (GBS) neonatal sepsis with combined maternal and neonatal chemoprophylaxis. METHODS:Since 1995, GBS chemoprophylaxis at our institution has consisted of intrapartum antibiotic prophylaxis to all women with identified risk factors. In addition, a singl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182592451
更新日期:2012-07-01 00:00:00
abstract::Sixty-eight previously infertile patients with endometriosis who had delivered a child tried to conceive again. Fifty-two of them were successful, 28 within 1 year, and 16 were not. The ability to conceive a second child was uniformly good regardless of the stage of the previous disease, the method of treatment, the d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198812000-00020
更新日期:1988-12-01 00:00:00
abstract::The current literature suggests that atypical (benign atypia or class II) Papanicolaou smears occur at a frequency of 1.6-5.4% and are associated with a substantial rate of underlying cervical dysplasia. However, we noted that our rate of atypia exceeded these figures, particularly in our clinic population. To quantif...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-08-01 00:00:00
abstract::All 119 medical schools in the United States provided information for a study of academic manpower conducted by the Association of Professors of Gynecology and Obstetrics (APGO). The average number of full-time faculty members per medical school is 13.2, with 2 positions vacant per school. Subspecialists are concentra...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-05-01 00:00:00
abstract::The diagnosis of a cervical ectopic pregnancy is often made intraoperatively in the presence of extensive hemorrhage during attempted evacuation. In some cases, hysterectomy has been the necessary treatment to control bleeding. We report two cases of cervical pregnancy detected by ultrasound. Before pregnancy terminat...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To examine the associations of maternal and child characteristics with early pregnancy maternal concentrations of testosterone, androstenedione, progesterone, 17-hydroxyprogesterone, and estradiol (E2). METHODS:We analyzed these hormones among 1,343 women with singleton pregnancies who donated serum samples ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182342b7f
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To evaluate whether current Joint Commission (JC) exclusion criteria for measure PC-01, "Elective Delivery" before 39 weeks of gestation, accurately identify valid, codeable indications for planned early-term delivery. METHODS:We performed a review and critical analysis of all cases recorded as noncompliant ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000059
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of the metabolic syndrome postpartum in women with a history of pregnancy complicated by early-onset vascular disorders compared with women with late-onset disorders. METHODS:In this retrospective cohort study 849 women with a history of pregnancy complicated by vascular disorders...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181b7b242
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To quantify preferences for female providers among obstetric-gynecology patients in a large military teaching hospital in California. METHODS:A questionnaire regarding patient preferences for female provider was distributed to and collected from 1,544 obstetric-gynecology patients over a two-month period. Re...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000156297.25395.e4
更新日期:2005-04-01 00:00:00
abstract::Cervical softening by vaginal administration of a prostaglandin E1 analogue (ONO-802) was studied in a double-blind, placebo-controlled study using an objective measure of cervical resistance in 121 women undergoing first trimester induced abortion. Three hours after administration, cervical resistance in control and ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Sixty percent of American Indian and Alaska Native women live in metropolitan areas. Most are not eligible for health care provided by the federal Indian Health Service (IHS). The IHS partly funds 34 Urban Indian Health Organizations, which vary in size and services. Some are small informational and referral sites tha...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000410162.34363.0b
更新日期:2012-01-01 00:00:00
abstract::In a comparative trial, ethanol effectively arrested preterm labor for 48 hours for more in 32% of cases, a beta-adrenergic agent (salbutamol) in 60% of cases (not statistically significant), and a combination of ethanol and indomethacin in 70% of cases (statistically significant, P less than 0.5). Labor was delayed f...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:Cerebral metastasis of choriocarcinoma during pregnancy is rare. Described is the fourth case in the literature. CASE:A pregnant women at 28 weeks' gestation sought care for headaches followed by loss of consciousness. The diagnosis of choriocarcinoma metastases was made on the basis of the combination of c...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/s0029-7844(03)00865-2
更新日期:2003-12-01 00:00:00
abstract::Tamoxifen, a nonsteroidal antiestrogen agent, is widely used as adjunctive therapy for women with breast cancer, and it has been approved by the U.S. Food and Drug Administration for adjuvant treatment of breast cancer, treatment of metastatic breast cancer, and reduction in breast cancer incidence in high-risk women....
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000450757.18294.cf
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To determine risk factors for hysterectomy, pelvic pain, and continued menorrhagia after rollerball endometrial ablation. METHODS:All women having rollerball endometrial ablations between 1990 and 2000 were sent standardized questionnaires on pre- and postablation symptoms, satisfaction with the ablation, an...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02185-3
更新日期:2002-10-01 00:00:00
abstract::"Female genital cosmetic surgery" is a broad term that comprises numerous procedures, including labiaplasty, clitoral hood reduction, hymenoplasty, labia majora augmentation, vaginoplasty, and G-spot amplification. Both patient interest in and performance of cosmetic genital procedures have increased during the past d...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1097/AOG.0000000000003617
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To describe a second-stage partogram based on a system of scoring the descent and position of the fetal head and to use this system for studying progress in the second stage of labor and predicting mode of delivery and obstetric outcome. METHODS:A prospective observational study of 1413 women at term with a ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)00981-9
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:To evaluate postpartum blood loss in women with treated intrahepatic cholestasis of pregnancy. METHODS:In a retrospective case-control study, 15,083 deliveries including 348 women with intrahepatic cholestasis of pregnancy (2.3%) were analyzed from 2004 to 2014. To adjust for differences in baseline characte...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000001693
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To compare the effects of single and repeated courses of corticosteroids on brain growth in fetal sheep. METHODS:Pregnant sheep were given intramuscular betamethasone (0.5 mg/kg) at 104 days' gestation followed at 111, 118, and 124 days by equivalent volumes of sterile normal saline (n = 12) or betamethasone...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00265-3
更新日期:1999-08-01 00:00:00