Association of Pharmacist Prescription of Hormonal Contraception With Unintended Pregnancies and Medicaid Costs.


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.


Obstet Gynecol


Rodriguez MI,Hersh A,Anderson LB,Hartung DM,Edelman AB




Has Abstract


2019-06-01 00:00:00














  • Association of E. coli sepsis in pregnancy with a CU-7 intrauterine device in place.

    abstract::Several reports of pregnancy and sepsis associated with an intrauterine device have been reported. A case of a CU-7 in utero with sepsis due to Escherichia coli in a 10-12 week gestation is presented. ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Propper NS,Moore JH

    更新日期:1976-07-01 00:00:00

  • Significance of polymicrobial bacterial superinfection in the therapy of gonococcal endometritis-salpingitis-peritonitis.

    abstract::The application of sophisticated anaerobic technology coupled with culdocentesis has radically altered out concepts of endometritis-salpingitis-peritonitis (ESP). The demonstration of a polymicrobial predominantly anaerobic peritonitis in selected cases of ESP polarized conceptual thought into gonococcal and nongonoco...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审


    authors: Monif GR

    更新日期:1980-05-01 00:00:00

  • Repetitive conservative surgery for recurrence of endometriosis.

    abstract::We evaluated the recovery of fertility and the relief of pain symptoms in a long-term follow-up of 42 women undergoing repetitive conservative surgery for recurrent endometriosis. The mean age of the patients was 31.1 +/- 4.3 years. At the time of their second operation the disease was stage IV in 14 women, stage III ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Candiani GB,Fedele L,Vercellini P,Bianchi S,Di Nola G

    更新日期:1991-03-01 00:00:00

  • Diagnosis of chlamydial infection in pregnant women using the Testpack Chlamydia diagnostic kit.

    abstract::We compared the performance of Testpack Chlamydia to tissue culture isolation for detection of endocervical chlamydia in an obstetric clinic population at high risk for infection. Among 227 evaluable patients, 30 tissue culture-confirmed chlamydial infections were found (13.2%). The sensitivity, specificity, and posit...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Grossman JH 3rd,Rivlin ME,Morrison JC

    更新日期:1991-05-01 00:00:00

  • Maternal hemodynamics and impaired fetal growth in pregnancy-induced hypertension.

    abstract::Twenty-one subjects with pregnancy-induced hypertension were investigated with regard to the relationship between maternal hemodynamics and fetal growth. Five of the infants were small for gestational age (SGA) (less than tenth percentile) and 16 were appropriate for gestational age (AGA) (greater than tenth percentil...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Nisell H,Lunell NO,Linde B

    更新日期:1988-02-01 00:00:00

  • HLA-DQB1 and HLA-DPB1 genotypes in severe preeclampsia.

    abstract:OBJECTIVE:To clarify whether there are susceptible HLA-DQB1 or HLA-DPB1 alleles in women with preeclampsia. METHODS:The frequency of HLA-DQB1 and HLA-DPB1 alleles was analyzed in 47 women with previous severe preeclampsia and compared with that in 85 normal fertile women. The types of HLA-DQB1 and HLA-DPB1 alleles wer...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Honda K,Takakuwa K,Hataya I,Yasuda M,Kurabayashi T,Tanaka K

    更新日期:2000-09-01 00:00:00

  • Soft cup vacuum extraction: a comparison of outlet delivery.

    abstract::One hundred eighteen nulliparous patients delivered under conduction anesthesia who met the standard criteria for low forceps delivery were randomly assigned to one of three groups to be delivered by low Tucker-McLane forceps, Silastic vacuum extraction system, or Mityvac vacuum extractor. Significant maternal soft ti...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Dell DL,Sightler SE,Plauché WC

    更新日期:1985-11-01 00:00:00

  • Cefmenoxime therapy for gynecologic and obstetric infections.

    abstract::Cefmenoxime, a new third-generation cephalosporin, was used as a single drug in the therapy for female genital tract infections. Therapeutic response was considered satisfactory in 21 of 22 cases of pelvic inflammatory disease, six of nine tuboovarian abscesses, two of three severe wound infections, and all five cases...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Rao B,Savage EW,Chuah SK,Bansal MB,Dhawan VK,Thadepalli H

    更新日期:1985-09-01 00:00:00

  • Pregnancy and reproductive function in a patient with non-mosaic Turner syndrome.

    abstract::A patient with non-mosaic Turner syndrome and normal fertility had four documented pregnancies, two of which were carried to term. Although her fertility history can be considered normal, she did not have spontaneous sexual maturation or menarche, and bilateral streak gonads were identified on laparotomy for tubal lig...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Baudier MM,Chihal HJ,Dickey RP

    更新日期:1985-03-01 00:00:00

  • The effect of loop electrosurgical excision procedure on future pregnancy outcome.

    abstract:OBJECTIVE:To estimate whether the loop electrosurgical excision procedure (LEEP) is associated with an adverse effect on the outcome of subsequent pregnancies. METHODS:A retrospective cohort study was performed. The study group comprised women who had a LEEP in Halifax County between 1992 and 1999 and then had a subse...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Samson SL,Bentley JR,Fahey TJ,McKay DJ,Gill GH

    更新日期:2005-02-01 00:00:00

  • Cardiovascular effects of ritodrine tocolysis: a new noninvasive method to measure pulmonary capillary pressure during pregnancy.

    abstract::The cardiovascular effects of ritodrine tocolytic therapy were assessed by noninvasive simultaneous recordings of indirect carotid pulse, electrocardiogram (ECG), phonocardiogram, and M-mode echocardiogram in 12 patients in preterm labor. The study was performed before and during infusion, and afterward when the patie...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Hadi HA,Abdulla AM,Fadel HE,Stefadouros MA,Metheny WP

    更新日期:1987-10-01 00:00:00

  • Routine fetal heart rate monitoring in the antepartum period.

    abstract::A total of 4517 successful antepartum nonstress tests (NST) was performed on 2003 high- (28%) and low- (72%) risk obstetric patients. Most patients were monitored from 32 to 34 weeks' gestation onward. A reactive NST was defined as 2 accelerations in 10 minutes--15 beats/min minimum amplitude; 15 seconds minimum durat...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Schifrin BS,Foye G,Amato J,Kates R,MacKenna J

    更新日期:1979-07-01 00:00:00

  • Trends and Predictors of Cerclage Use in the United States From 2005 to 2012.

    abstract:OBJECTIVE:To characterize the use of cervical cerclage on a population basis. METHODS:This population-based study of U.S. natality records from 2005 to 2012 evaluated use of cerclage in singleton and multiple gestation live births. Obstetric, medical, and demographic characteristics were evaluated. A multivariable log...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Friedman AM,Ananth CV,Siddiq Z,D'Alton ME,Wright JD

    更新日期:2015-08-01 00:00:00

  • Gestational Alloimmune Liver Disease: A Devastating Condition Preventable With Maternal Intravenous Immunoglobulin.

    abstract:BACKGROUND:Gestational alloimmune liver disease, a form of profound liver failure in the newborn, is the main underlying cause of the entity formerly known as neonatal hemochromatosis. Antepartum maternal intravenous immunoglobulin (IVIG) has been shown to prevent gestational alloimmune liver disease, which otherwise h...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Anastasio HB,Grundy M,Birsner ML,Blakemore KJ

    更新日期:2016-11-01 00:00:00

  • Racial and Ethnic Disparities in Maternal and Neonatal Adverse Outcomes in College-Educated Women.

    abstract:OBJECTIVE:To compare composite maternal and neonatal adverse outcomes among women with at least a bachelor's degree by racial and ethnic groups. METHODS:This was a retrospective cohort study using the U.S. vital statistics data sets. We included women with at least a bachelor's degree who delivered a nonanomalous live...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Tanner LD,Chen HY,Sibai BM,Chauhan SP

    更新日期:2020-07-01 00:00:00

  • A simple visual assessment technique to discriminate between menorrhagia and normal menstrual blood loss.

    abstract:OBJECTIVE:To validate a simple, highly predictive test to discriminate between menorrhagia and normal menstrual blood loss. METHODS:The sanitary wear of 489 menstrual bleeding episodes was collected by 288 women for objective measurement of menstrual blood loss (alkaline hematin method); the women made a subjective as...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章


    authors: Janssen CA,Scholten PC,Heintz AP

    更新日期:1995-06-01 00:00:00

  • Hysterectomy Practice Patterns in the Postmorcellation Era.

    abstract:OBJECTIVE:To characterize long-term national trends in surgical approach for hysterectomy after the U.S. Food and Drug Administration (FDA) warning against power morcellation for laparoscopic specimen removal. METHODS:This was a descriptive study using data from the American College of Surgeons National Surgical Quali...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Jorgensen EM,Modest AM,Hur HC,Hacker MR,Awtrey CS

    更新日期:2019-04-01 00:00:00

  • Loop electrosurgical excision procedure for squamous intraepithelial lesions of the cervix: advantages and potential pitfalls.

    abstract:OBJECTIVE:to evaluate the advantages and pitfalls of the loop electrosurgical excision procedure as applied to the diagnosis and treatment of cervical cancer precursors. METHODS:Loop electrosurgical excision procedure using local anesthesia and colposcopic guidance was performed in an outpatient clinical setting in 11...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Ferenczy A,Choukroun D,Arseneau J

    更新日期:1996-03-01 00:00:00

  • Lynch syndrome in women less than 50 years of age with endometrial cancer.

    abstract:OBJECTIVE:To estimate the frequency of mismatch repair deficiencies associated with hereditary nonpolyposis colorectal cancer, or Lynch syndrome, in women less than age 50 with endometrial cancer. METHODS:Consecutive patients less than age 50 diagnosed with endometrial adenocarcinoma were identified. Available patholo...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Matthews KS,Estes JM,Conner MG,Manne U,Whitworth JM,Huh WK,Alvarez RD,Straughn JM Jr,Barnes MN,Rocconi RP

    更新日期:2008-05-01 00:00:00

  • Expectant management of twin pregnancies discordant for anencephaly.

    abstract:OBJECTIVE:To study the clinical course and perinatal outcome of twin pregnancies discordant for anencephaly, without selective termination. METHODS:We conducted a descriptive retrospective study of 14 cases of dichorionic twin pregnancies discordant for anencephaly, which were managed expectantly in five Israeli perin...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Lipitz S,Meizner I,Yagel S,Shapiro I,Achiron R,Schiff E

    更新日期:1995-12-01 00:00:00

  • Elevated circulating levels of a decidual protein, placental protein 12, in preeclampsia.

    abstract::The serum concentration of placental protein 12 was measured by radioimmunoassay in 111 apparently healthy pregnant women at 33 to 40 weeks, and the results were compared with those of 39 women with preeclampsia either with or without proteinuria at similar stages of pregnancy. Because the placental protein 12 levels ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Iino K,Sjöberg J,Seppälä M

    更新日期:1986-07-01 00:00:00

  • Functional ovarian cysts in relation to the use of monophasic and triphasic oral contraceptives.

    abstract::This population-based case-control study assessed the effect of current use of monophasic or triphasic oral contraceptives (OCs) on the risk of functional ovarian cyst development. The cases were all 15-39-year-old enrollees in the Group Health Cooperative of Puget Sound who had either an inpatient primary diagnosis o...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Holt VL,Daling JR,McKnight B,Moore D,Stergachis A,Weiss NS

    更新日期:1992-04-01 00:00:00

  • Scheduled hysterectomy for second-trimester abortion in a patient with placenta accreta.

    abstract:BACKGROUND:As cesarean deliveries increase, so does placenta accreta. There is little evidence regarding management of patients with known or suspected abnormal placentation seeking abortion. CASE:A medically complicated patient with evidence of placenta increta on magnetic resonance imaging presented for pregnancy te...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Tocce K,Thomas VW,Teal S

    更新日期:2009-02-01 00:00:00

  • Early oral intake and gastrointestinal function after cesarean delivery: a systematic review and meta-analysis.

    abstract:OBJECTIVE:To evaluate whether early oral intake after cesarean delivery has an effect on gastrointestinal outcomes during postpartum recovery. DATA SOURCES:Electronic searches of published studies between 1980 and 2011 were conducted using PubMed, Medline, CINAHL,, and Airiti databases. METHODS OF ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,meta分析,评审


    authors: Hsu YY,Hung HY,Chang SC,Chang YJ

    更新日期:2013-06-01 00:00:00

  • Contraceptive Practices Among Female Cancer Survivors of Reproductive Age.

    abstract:OBJECTIVE:To compare rates of contraception between reproductive-aged cancer survivors and women in the general U.S. POPULATION:Among survivors, the study examined factors associated with use of contraception and emergency contraception. METHODS:This study analyzed enrollment data from an ongoing national prospective...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Dominick SA,McLean MR,Whitcomb BW,Gorman JR,Mersereau JE,Bouknight JM,Su HI

    更新日期:2015-09-01 00:00:00

  • Hormone replacement therapy after transcervical resection of the endometrium.

    abstract:OBJECTIVE:To determine if women who have undergone transcervical resection of the endometrium can be treated safely with estrogens alone. METHODS:Sixty-two postmenopausal women who had undergone endometrial resection were recruited into a double-blind, randomized study. Twenty-one had menopausal symptoms at the primar...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Istre O,Holm-Nielsen P,Bourne T,Forman A

    更新日期:1996-11-01 00:00:00

  • Student doctors and women in labor: attitudes and expectations.

    abstract:OBJECTIVE:To compare the attitudes and expectations that obstetric patients and medical students bring to the student-patient relationship in intrapartum care. METHODS:Written questionnaires were distributed to obstetric patients who had students assist in their labor and delivery care and to medical students who had ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Magrane D,Gannon J,Miller CT

    更新日期:1996-08-01 00:00:00

  • Group B Streptococci Screening Before Repeat Cesarean Delivery: A Cost-Effectiveness Analysis.

    abstract:OBJECTIVE:To estimate the cost-effectiveness of universal group B streptococci (GBS) screening in women with a singleton pregnancy planning a repeat cesarean delivery. METHODS:We conducted a decision analysis from a health care perspective to compare the cost-effectiveness of GBS screening for women planning a repeat ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Albright CM,MacGregor C,Sutton D,Theva M,Hughes BL,Werner EF

    更新日期:2017-01-01 00:00:00

  • Evaluation of the endocervical Cytobrush and Cervex-Brush in pregnant women.

    abstract:OBJECTIVE:To compare, in pregnant women, the endocervical cell yield of the Cytobrush Cell Collector and the Cervex-Brush Cell Sampler with the standard cotton swab, and to determine the incidence of serious adverse events associated with the collection techniques. METHODS:In a randomized, controlled clinical trial, 3...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Paraiso MF,Brady K,Helmchen R,Roat TW

    更新日期:1994-10-01 00:00:00

  • Mechanisms of action of regulatory T cells specific for paternal antigens during pregnancy.

    abstract:OBJECTIVE:To investigate whether pregnancy-induced regulatory T cells are generated specifically for paternal antigens or expanded by hormonal changes and to study regulatory T cell-related mechanisms during pregnancy. METHODS:We used murine models of normal, abortion-prone, and pseudopregnancy to characterize regulat...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章


    authors: Schumacher A,Wafula PO,Bertoja AZ,Sollwedel A,Thuere C,Wollenberg I,Yagita H,Volk HD,Zenclussen AC

    更新日期:2007-11-01 00:00:00