Valuable safeguard or unnecessary burden? Characterization of physician consultations for oral contraceptive use in Mexico City.
BACKGROUND
Given the safety and efficacy of oral contraceptives (OCs), many health professionals believe that these should be widely available over-the-counter (OTC). Opponents of OTC availability argue that without a physician's consultation, women will not be properly screened and will not use OCs correctly, thereby compromising safety and efficacy. However, little is known about the content or quality of physicians' consultations.


METHODS
Trained simulated patients (SPs) attended 45 appointments with Mexico City public and private physicians to request a prescription for OCs. Immediately following each appointment, the SPs filled out a checklist regarding the information provided and examinations performed by physicians.


RESULTS
Both public and private physicians asked a few questions and provided little information regarding screening, pill-taking instructions, side effect information and warning sign information. Despite the fact that all SPs were appropriate OC candidates, women were denied a prescription in seven (15.6%) appointments mostly because of their age (regarded as either too old or too young).


CONCLUSIONS
In general, Mexican physicians are not providing women thorough information and screening in OC consultations, calling into question the assumption that a physician's appointment is necessary for or will ensure safe, proper OC use.
Tatum
Carrie
C
Population Council, Regional Office for Latin America and the Caribbean, Mexico City, DF 04000, Mexico.
Garcia
Sandra G
SG
Goldman
Lisa
L
Becker
Davida
D
D003276:Contraceptives, Oral / Q000008:administration & dosage / Q000009:adverse effects; D037001:Directive Counseling / Q000592:standards; D011307:Drug Prescriptions / Q000592:standards; D005260:Female; D006801:Humans; D008800:Mexico; D010819:Physician's Role; D010820:Physicians / Q000592:standards; D011787:Quality of Health Care / Q000592:standards*; D011795:Surveys and Questionnaires
D003276:Contraceptives, Oral