ASSESSMENT OF SAFETY OF HORMONAL CONTRACEPTIVES USING PATIENT MEDICAL HISTORY

• Main Authors: E. A. Lebedeva, I. Yu. Nefedov, I. Yu. Nefedova
• Format: Article
• Language: Russian
• Published: Private institution educational organization of higher education "Medical University "ReaViz" 2020-11-01
• Series: Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье
• Subjects: hormonal contraceptives; safety and ethics of use; women's health; general practitioner; educational work of a pharmacist
• Online Access: https://vestnik.reaviz.ru/jour/article/view/45

According to the National Project ‘Demography,’ cumulative birth rate per 1 woman should increase from 1.62 in 2017 to 1.70 in 2024. From an ethical point of view, the use of hormonal contraceptives is unacceptable due to their abortive effect. However, there is an increasing number of women taking these drugs, often, without a doctor's consultation, despite potential contraindications and risks to their health they are unaware about. Such women usually visit their general practitioner (GP) in case of any health problems; therefore, a GP should take into account this factor as a potential cause of pathological conditions and assess the safety of using contraceptives.The analysis of patients' awareness of the effect of hormonal contraceptives demonstrated that 30% to 60% of women do not know about all negative effects of these drugs on their own health and the health of their future children. More than 30% of respondents did not know about the abortive effect of hormonal contraceptives; 70% of women considered this information important. Approximately half of all women using these drugs did not know about the risk of neural tube defects in the fetus, increasing insulin resistance, and stopping the production of their own sex hormones. In general, our findings indicate insufficient patient awareness of the effects of hormonal contraceptives the need for doctor consultation and appropriate educational work of pharmacists among the population. The analysis of patients’ histories (those who were currently taking hormonal contraceptives or used them in the past; n = 12) demonstrated that 91.7% of them (11 women) had contraindications or health risks. Among 7 patients taking these drugs, 5 women (71.4%) were found to be at risk of developing thrombosis, 1 woman (14.3 %) had contraindications, and only 1 woman (14.3 %) had no contraindications or risks. The assessment of hormonal contraceptive safety using patients’ histories and drug package inserts, showed that 2 out of 7 patients should stop taking oral contraceptive and 4 patients can continue using them with caution. From an ethical point of view, 5 out of 7 patients can be recommended to stop taking the drug, since information about the abortive effect of hormonal contraceptives is important for them.