[AF] La píldora del día después en Farmacias y sin receta

[Antonio Villafaina Barroso]

Muchas Gracias a ti  Flor, la gente tiene maestros y referentes a los que intentar seguir tú eres uno de los referentes claros en este mundo.

Más cosas por si a alguien le sirve; Revisión Cochrane de 2007 de la que traduzco búrdamente las conclusiones. el abstrac original lo podeis descargar de 
http://www.ncbi.nlm.nih.gov/pubmed/18055735
o en
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salu2

El
anticipo de la anticoncepción de emergencia no reduce las tasas de
embarazo en comparación con la provisión convencional. Tampoco
repercute negativamente en los comportamientos y en los resultados
relacionados con la salud sexual y reproductiva. Las mujeres deben
tener fácil acceso a la anticoncepción de emergencia, porque puede
disminuir la probabilidad de embarazo. Sin embargo, las intervenciones
probadas hasta ahora no han reducido en general las tasas de embarazo
en las poblaciones estudiadas.

Advance provision of emergency contraception for pregnancy prevention (full review).   
Polis CB, Schaffer K, Blanchard K, Glasier A, Harper CC, Grimes DA.   

Johns Hopkins Bloomberg School of Public Health, Department of Population,
Family and Reproductive Health, Room W4510, 615 N. Wolfe St, Baltimore,
Maryland 21205, USA. cpolis en jhsph.eduummarize randomized controlled
trials evaluating advance provision of emergency contraception to
explore effect   BACKGROUND: Emergency
contraception can prevent pregnancy when taken after unprotected
intercourse. Obtaining emergency contraception within the recommended
time frame is difficult for many women. Advance provision, in which
women receive a supply of emergency contraception before unprotected
sex, could circumvent some obstacles to timely use. OBJECTIVES: To
summarize randomized controlled trials evaluating advance provision of
emergency contraception to explore effects on pregnancy rates, sexually
transmitted infections, and sexual and contraceptive behaviors. SEARCH
STRATEGY: In August 2006, we searched CENTRAL, EMBASE, POPLINE, MEDLINE
via PubMed, and a specialized emergency contraception article database.
We also searched reference lists and contacted experts to identify
additional published or unpublished trials. SELECTION CRITERIA: We
included randomized controlled trials comparing advance provision and
standard access, which was defined as any of the following: counseling
which may or may not have included information about emergency
contraception, or provision of emergency contraception on request at a
clinic or pharmacy. DATA COLLECTION AND ANALYSIS: We evaluated all
identified titles and abstracts found for potential inclusion. Two
reviewers independently abstracted data and assessed study quality. We
entered and analyzed data using RevMan 4.2.8. We calculated odds ratios
with 95% confidence intervals for dichotomous data and weighted mean
differences with 95% confidence intervals for continuous data. MAIN
RESULTS: Eight randomized controlled trials met our criteria for
inclusion, representing 6389 patients in the United States, China and
India. Advance provision did not decrease pregnancy rates (OR 1.0; 95%
CI: 0.78 to 1.29 in studies for which we included twelve month
follow-up data; OR 0.91; 95% CI: 0.69 to 1.19 in studies for which we
included six month follow-up data; OR 0.49; 95% CI: 0.09 to 2.74 in a
study with three month follow up data), despite increased use (single
use: OR 2.52; 95% CI 1.72 to 3.70; multiple use: OR 4.13; 95% CI 1.77
to 9.63) and faster use (weighted mean difference (WMD) -14.6 hours;
95% CI -16.77 to -12.4 hours). Advance provision did not lead to
increased rates of sexually transmitted infections (OR 0.99; 95% CI
0.73 to 1.34), increased frequency of unprotected intercourse, nor
changes in contraceptive methods. Women who received emergency
contraception in advance were equally as likely to use condoms as other
women. AUTHORS' CONCLUSIONS: Advance provision of emergency
contraception did not reduce pregnancy rates when compared to
conventional provision. Advance provision does not negatively impact
sexual and reproductive health behaviors and outcomes. Women should
have easy access to emergency contraception, because it can decrease
the chance of pregnancy. However, the interventions tested thus far
have not reduced overall pregnancy rates in the populations studied. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD005497.Antonio Villafaina Barroso
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