File Download
 
 
Supplementary

Postgraduate Thesis: Novel use of emergency contraceptive pills in Hong Kong
  • Basic View
  • Metadata View
  • XML View
TitleNovel use of emergency contraceptive pills in Hong Kong
 
AuthorsLo, Seen-tsing, Sue.
羅善清.
 
Issue Date2012
 
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
 
AbstractEmergency contraception is an effective backup for contraceptive failure. In Hong Kong, levonorgestrel emergency contraceptive pill is a prescription drug. In most developed countries, it is provided in advance or over-the-counter to eliminate the barrier to access. The objective of this thesis is to evaluate the feasibility and acceptability of these novel delivery modes in Hong Kong. Four studies were conducted to study pertinent subject matters. A retrospective review on 11014 clinical records of The Family Planning Association of Hong Kong on emergency contraception prescription between 2006 and 2008 was performed to delineate the characteristics of emergency contraceptive users. One-year follow-up data was available in 4728 records, with 89.4% used emergency contraception once and 8.5% used it twice. The proportion of subjects not using ongoing contraceptives reduced from 20.6% at the emergency contraception visit to 4.5% at post-treatment follow-up, 3.9% at 6th month and 3.3% at 12th month. Young age was not associated with not using ongoing contraceptives and repeat use of emergency contraceptives. A randomized controlled trial with 1030 women was conducted to compare the behavior of those given three courses of levonorgestrel emergency contraceptive pills in advance against those who had to get them from clinics when needed. After one year, 29.9% of women in the advanced provision group had used the pills versus 12.9% in the control group (odds ratio 2.87, 95% confidence interval 2.07-3.97). The advanced provision group used three times more pills than the control group (278 versus 95 courses, p<0.001). The median coitus-treatment interval in the advanced provision group was significantly shorter than the control group (11 h versus 20 h; p<0.001). Most women used condoms before (90%) and during (89%) the study. In both groups, consistency of use was higher after emergency contraception (65%) than before (60%) (p<0.001). This study confirmed that advanced provision increased the utilization of emergency contraceptive pill, facilitated its early use and did not hamper ongoing contraceptive use. A questionnaire survey was conducted to evaluate the acceptability of novel use of emergency contraceptive pill among women practicing contraception. Of the 1405 questionnaires analyzed, 46.3% of women supported more advertising on emergency contraception; 48.7% supported advanced provision of emergency contraceptive pill and 25.7% supported over-the-counter provision. Another questionnaire survey assessed the attitude of physicians who provide family planning services. Half (54.2%) of them supported advanced provision of emergency contraceptive pill; 32.5% supported advanced provision to girls aged 16 and below and 40.2% supported over-thecounter provision. Among 352 physicians who provided emergency contraception, only 21.7% of private family physicians and 15.9% of private obstetrician-gynaecologists prescribed emergency contraceptive pills in advance. In conclusion, local women used emergency contraception responsibly and remained vigilant with ongoing contraception even when they got pills in advance. Minority of physicians practice advanced provision. The acceptance of advanced provision, among women and physicians who do not know much about it, is around 50%. It is thus possible to improve when more education on advanced provision is provided. The support for over-the-counter provision was too weak to boost.
 
DegreeDoctor of Medicine
 
SubjectEmergency contraceptives - China - Hong Kong.
 
Dept/ProgramMedicine
 
DC FieldValue
dc.contributor.authorLo, Seen-tsing, Sue.
 
dc.contributor.author羅善清.
 
dc.date.hkucongregation2012
 
dc.date.issued2012
 
dc.description.abstractEmergency contraception is an effective backup for contraceptive failure. In Hong Kong, levonorgestrel emergency contraceptive pill is a prescription drug. In most developed countries, it is provided in advance or over-the-counter to eliminate the barrier to access. The objective of this thesis is to evaluate the feasibility and acceptability of these novel delivery modes in Hong Kong. Four studies were conducted to study pertinent subject matters. A retrospective review on 11014 clinical records of The Family Planning Association of Hong Kong on emergency contraception prescription between 2006 and 2008 was performed to delineate the characteristics of emergency contraceptive users. One-year follow-up data was available in 4728 records, with 89.4% used emergency contraception once and 8.5% used it twice. The proportion of subjects not using ongoing contraceptives reduced from 20.6% at the emergency contraception visit to 4.5% at post-treatment follow-up, 3.9% at 6th month and 3.3% at 12th month. Young age was not associated with not using ongoing contraceptives and repeat use of emergency contraceptives. A randomized controlled trial with 1030 women was conducted to compare the behavior of those given three courses of levonorgestrel emergency contraceptive pills in advance against those who had to get them from clinics when needed. After one year, 29.9% of women in the advanced provision group had used the pills versus 12.9% in the control group (odds ratio 2.87, 95% confidence interval 2.07-3.97). The advanced provision group used three times more pills than the control group (278 versus 95 courses, p<0.001). The median coitus-treatment interval in the advanced provision group was significantly shorter than the control group (11 h versus 20 h; p<0.001). Most women used condoms before (90%) and during (89%) the study. In both groups, consistency of use was higher after emergency contraception (65%) than before (60%) (p<0.001). This study confirmed that advanced provision increased the utilization of emergency contraceptive pill, facilitated its early use and did not hamper ongoing contraceptive use. A questionnaire survey was conducted to evaluate the acceptability of novel use of emergency contraceptive pill among women practicing contraception. Of the 1405 questionnaires analyzed, 46.3% of women supported more advertising on emergency contraception; 48.7% supported advanced provision of emergency contraceptive pill and 25.7% supported over-the-counter provision. Another questionnaire survey assessed the attitude of physicians who provide family planning services. Half (54.2%) of them supported advanced provision of emergency contraceptive pill; 32.5% supported advanced provision to girls aged 16 and below and 40.2% supported over-thecounter provision. Among 352 physicians who provided emergency contraception, only 21.7% of private family physicians and 15.9% of private obstetrician-gynaecologists prescribed emergency contraceptive pills in advance. In conclusion, local women used emergency contraception responsibly and remained vigilant with ongoing contraception even when they got pills in advance. Minority of physicians practice advanced provision. The acceptance of advanced provision, among women and physicians who do not know much about it, is around 50%. It is thus possible to improve when more education on advanced provision is provided. The support for over-the-counter provision was too weak to boost.
 
dc.description.naturepublished_or_final_version
 
dc.description.thesisdisciplineMedicine
 
dc.description.thesislevelmaster's
 
dc.description.thesisnameDoctor of Medicine
 
dc.identifier.hkulb4827357
 
dc.languageeng
 
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)
 
dc.relation.ispartofHKU Theses Online (HKUTO)
 
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.source.urihttp://hub.hku.hk/bib/B48273570
 
dc.subject.lcshEmergency contraceptives - China - Hong Kong.
 
dc.titleNovel use of emergency contraceptive pills in Hong Kong
 
dc.typePG_Thesis
 
<?xml encoding="utf-8" version="1.0"?>
<item><contributor.author>Lo, Seen-tsing, Sue.</contributor.author>
<contributor.author>&#32645;&#21892;&#28165;.</contributor.author>
<date.issued>2012</date.issued>
<description.abstract>&#65279;Emergency contraception is an effective backup for contraceptive failure. In

Hong Kong, levonorgestrel emergency contraceptive pill is a prescription drug.

In most developed countries, it is provided in advance or over-the-counter to

eliminate the barrier to access. The objective of this thesis is to evaluate the

feasibility and acceptability of these novel delivery modes in Hong Kong. Four

studies were conducted to study pertinent subject matters.

A retrospective review on 11014 clinical records of The Family Planning

Association of Hong Kong on emergency contraception prescription between

2006 and 2008 was performed to delineate the characteristics of emergency

contraceptive users. One-year follow-up data was available in 4728 records,

with 89.4% used emergency contraception once and 8.5% used it twice. The

proportion of subjects not using ongoing contraceptives reduced from 20.6% at

the emergency contraception visit to 4.5% at post-treatment follow-up, 3.9% at

6th month and 3.3% at 12th month. Young age was not associated with not

using ongoing contraceptives and repeat use of emergency contraceptives.

A randomized controlled trial with 1030 women was conducted to compare the

behavior of those given three courses of levonorgestrel emergency

contraceptive pills in advance against those who had to get them from clinics

when needed. After one year, 29.9% of women in the advanced provision

group had used the pills versus 12.9% in the control group (odds ratio 2.87,

95% confidence interval 2.07-3.97). The advanced provision group used three

times more pills than the control group (278 versus 95 courses, p&lt;0.001). The

median coitus-treatment interval in the advanced provision group was

significantly shorter than the control group (11 h versus 20 h; p&lt;0.001). Most

women used condoms before (90%) and during (89%) the study. In both

groups, consistency of use was higher after emergency contraception (65%)

than before (60%) (p&lt;0.001). This study confirmed that advanced provision

increased the utilization of emergency contraceptive pill, facilitated its early

use and did not hamper ongoing contraceptive use.

A questionnaire survey was conducted to evaluate the acceptability of novel

use of emergency contraceptive pill among women practicing contraception.

Of the 1405 questionnaires analyzed, 46.3% of women supported more

advertising on emergency contraception; 48.7% supported advanced provision

of emergency contraceptive pill and 25.7% supported over-the-counter

provision. Another questionnaire survey assessed the attitude of physicians

who provide family planning services. Half (54.2%) of them supported

advanced provision of emergency contraceptive pill; 32.5% supported

advanced provision to girls aged 16 and below and 40.2% supported over-thecounter

provision. Among 352 physicians who provided emergency

contraception, only 21.7% of private family physicians and 15.9% of private

obstetrician-gynaecologists prescribed emergency contraceptive pills in

advance.

In conclusion, local women used emergency contraception responsibly and

remained vigilant with ongoing contraception even when they got pills in

advance. Minority of physicians practice advanced provision. The acceptance

of advanced provision, among women and physicians who do not know much

about it, is around 50%. It is thus possible to improve when more education on

advanced provision is provided. The support for over-the-counter provision

was too weak to boost.</description.abstract>
<language>eng</language>
<publisher>The University of Hong Kong (Pokfulam, Hong Kong)</publisher>
<relation.ispartof>HKU Theses Online (HKUTO)</relation.ispartof>
<rights>The author retains all proprietary rights, (such as patent rights) and the right to use in future works.</rights>
<rights>Creative Commons: Attribution 3.0 Hong Kong License</rights>
<source.uri>http://hub.hku.hk/bib/B48273570</source.uri>
<subject.lcsh>Emergency contraceptives - China - Hong Kong.</subject.lcsh>
<title>Novel use of emergency contraceptive pills in Hong Kong</title>
<type>PG_Thesis</type>
<identifier.hkul>b4827357</identifier.hkul>
<description.thesisname>Doctor of Medicine</description.thesisname>
<description.thesislevel>master&apos;s</description.thesislevel>
<description.thesisdiscipline>Medicine</description.thesisdiscipline>
<description.nature>published_or_final_version</description.nature>
<date.hkucongregation>2012</date.hkucongregation>
<bitstream.url>http://hub.hku.hk/bitstream/10722/173862/1/FullText.pdf</bitstream.url>
</item>