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E-grāmata: Contraceptive Research, Introduction, and Use: Lessons From Norplant

  • Formāts: 128 pages
  • Izdošanas datums: 03-Mar-1998
  • Izdevniecība: National Academies Press
  • Valoda: eng
  • ISBN-13: 9780309591539
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  • Formāts: 128 pages
  • Izdošanas datums: 03-Mar-1998
  • Izdevniecība: National Academies Press
  • Valoda: eng
  • ISBN-13: 9780309591539

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As the first real contraceptive innovation in over 20 years, and as a long-acting method requiring clinical intervention for application and removal, the implantable contraceptive Norplant has raised a wide range of issues that could offer valuable lessons about the problems to be addressed if other new contraceptive technologies are to enter the marketplace. In April 1997 an Institute of Medicine workshop on implant contraceptives reviewed newly available data on Norplant's efficacy, safety, and use; identified lessons to be learned about the method's development, introduction, use, and market experience; and explored approaches to developing and introducing new contraceptives based on those lessons. This resulting book contains an examination of Norplant's efficacy and safety, its user populations, training for insertion and removal, consumer perspectives (quality of care, informed decisionmaking, and consumer involvement), and new approaches to contraceptive development and introduction. An appendix contains summaries of 17 workshop presentations.

Table of Contents



Front Matter 1 Introduction 2 Workshop Report 3 Workshop Summary and Analysis Appendix A: Presentation Summaries Appendix B: Norplant: Historical Background Appendix C: Workshop Agenda
1 INTRODUCTION
1(2)
2 WORKSHOP REPORT
3(34)
Efficacy and Safety
3(6)
Efficacy
3(1)
Safety
4(5)
Who Uses Norplant and How
9(14)
User Populations
9(2)
Method Continuation and Discontinuation
11(1)
Side Effects as Factors
12(1)
User Satisfaction
13(5)
Barriers to Discontinuation
18(5)
Insertion and Removal: Experience and Implications
23(4)
Technical Aspects
23(1)
Case Experiences
23(2)
Rates of Complicated Removals
25(1)
Implications
25(2)
Consumer Perspectives
27(4)
Communication and Quality of Care
27(1)
Informed Decision-Making
28(3)
Consumer Involvement
31(1)
New Approaches
31(6)
Reproductive Health Technologies Project's "Boom and But Initiative"
32(1)
The WHO Strategic Approach to Contraceptive Introduction
32(2)
A "Government Standards Defense"
34(3)
3 WORKSHOP SUMMARY AND ANALYSIS
37(22)
Data Review
38(3)
Efficacy
38(1)
Safety
38(1)
User Profiles
39(1)
Side Effects
39(1)
Continuation and Discontinuation
39(1)
User Satisfaction
40(1)
Postmarketing Surveillance
40(1)
Cost-Effectiveness
41(1)
Lessons Learned
41(3)
Next Steps: Areas for Consideration and Action
44(5)
Areas for Strengthening or Expansion
44(3)
Areas for New Initiative
47(2)
Final Comment
49(10)
APPENDIXES 59
A Presentation Summaries 59(48)
B Norplant: Historical Background 107(8)
C Workshop Agenda 115
Polly F. Harrison and Allan Rosenfield, Editors; Committee on Contraceptive Research and Development, Division of Health Sciences Policy