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首页> 外文期刊>The Internet Journal of Academic Physician Assistants >Assessing the factors that affect potential prescribing patterns of Plan B in UTMB Physician Assistant Students
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Assessing the factors that affect potential prescribing patterns of Plan B in UTMB Physician Assistant Students

机译：评估影响UTMB医师助理学生B计划潜在处方模式的因素

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There have been many research studies investigating the efficacy, availability, and need for emergency contraception. Many of the studies have demonstrated that personal beliefs and values of the health care provider play a role in whether or not the provider will prescribe emergency contraception. However, no studies have examined the specific values and beliefs that influence this decision. The aim of this study was to explore what values and beliefs play a role in physician assistant students' opinions on Plan B and whether or not they will prescribe it in the future. A non-random convenience sample of 129 students at The University of Texas Medical Branch (UTMB) was surveyed on a voluntary basis. The results showed that the strongest factor influencing students to prescribe Plan B in the future is the individual patient scenario, while the strongest factor influencing them to not prescribe Plan B is religious beliefs. The patient scenarios in which students are most likely to prescribe Plan B include a rape victim and younger age of the patient. Student beliefs on when life begins (fertilization vs. implantation or later) also play a role in whether or not they will prescribe Plan B, as does the amount of clinical hours they have had in Physician Assistant school. Differences in religion among participants do not seem to play a role in their decision to prescribe, however. The results of this study are noteworthy because they demonstrate that individual patient circumstances, more than religion or other factors, clearly play a role in whether or not future health care providers will prescribe Plan B or not. Introduction Plan B is the brand name for a progestin-only emergency contraceptive (EC), which contains the active ingredient, levonorgestrel. It interferes with ovulation, and possibly fertilization and implantation. It is not effective once implantation has begun (Definition of Plan B, 2004). The International Federation of Gynecologists and Obstetrics (FIGO) defines implantation as the beginning of pregnancy. A recent study showed that EC has little or no effect after ovulation; however it is very effective if taken before ovulation (Novikova, Weisberg, Stanczyk, Croxatto, Fraser, 2007). At the time when this current study began, research studies had shown inconsistent availability for women seeking Plan B. Furthermore, several studies have also indicated that personal values and beliefs of those with prescriptive authority influence whether or not they will prescribe Plan B or other EC (Fairhurst, Wyke, Ziebland, Seaman, & Glasier, 2005; Sable, Schwartz, Kelly, Lisbon, & Hall, 2006). It is necessary to understand not only the mechanism of action of Plan B, but also its availability and reasons for which patients request it. The Plan B regimen consists of one tablet, 0.75 mg of levonorgestrel followed by a second tablet, 0.75 mg, 12 hours later (Roye and Johnsen, 2002). It is designed to prevent pregnancy within 72 hours after a contraceptive accident or unprotected sex. It has been reported that Plan B is more effective with fewer side effects than other methods of EC, such as Yuzpe method, decreasing risk of pregnancy by 89% when used correctly (Task Force on Postovulatory Methods of Fertility Regulation [TFPMFR], 1998). In conclusion, it appears that Plan B is the most efficacious method of EC with the least side effects that is available today.When this research study began in 2006, Plan B was a product in the United States that was available by prescription only, with the exception of the states of Alaska, California, Hawaii, Massachusetts, New Hampshire, New Mexico and Washington (Sable, Schwartz, Kelly, Libson, & Hall, 2006). Many countries had already made emergency contraception available without a prescription, including the United Kingdom, South Africa, Israel and France, yet it remained restricted to prescription-only status in the United States (Pentel, Nelson, Wikelius, & Cooper, 2004). During the devel
机译：已经有许多研究研究紧急避孕的功效，可用性和需求。许多研究表明，医疗保健提供者的个人信念和价值观在提供者是否会开紧急避孕药具方面发挥着作用。但是，没有研究检查影响该决定的具体价值和信念。这项研究的目的是探讨什么价值观和信念在医师助理学生对计划B的意见中起着作用，以及他们是否将来会开具处方。自愿调查了德克萨斯大学医学分校（UTMB）的129名学生的非随机便利样本。结果表明，将来影响学生开处方B的最强因素是个人患者的情况，而影响他们不开处方B的最强因素是宗教信仰。学生最有可能开出B计划的患者场景包括强奸受害者和患者年龄较小。学生对于生命何时开始的信念（受精与植入或以后）对他们是否开处方B也有影响，他们在Physician Assistant学校的临床工作时间也是如此。然而，参与者之间的宗教差异似乎在他们决定开处方时并不起作用。这项研究的结果值得关注，因为它们表明，除了宗教或其他因素外，患者的具体情况显然会影响未来的医疗保健提供者是否会制定B计划。简介计划B是仅孕激素的紧急避孕药（EC）的商标名称，其中包含有效成分左炔诺孕酮。它会干扰排卵，并可能影响受精和植入。一旦开始植入，它就无效（B计划的定义，2004年）。国际妇产科联合会（FIGO）将植入定义为怀孕的开始。最近的一项研究表明，排卵后EC几乎没有或没有作用。但是，如果在排卵前服用，则非常有效（Novikova，Weisberg，Stanczyk，Croxatto，Fraser，2007年）。在本研究开始之时，研究表明，寻求B计划的女性的可用率不一致。此外，一些研究还表明，具有规定权威的人的个人价值观和信仰会影响他们是否会开B计划或其他EC （Fairhurst，Wyke，Ziebland，Seaman和Glasier，2005; Sable，Schwartz，Kelly，Lisbon和Hall，2006）。有必要不仅了解计划B的作用机理，而且还应了解其可用性和患者要求它的原因。计划B方案由12小时后的0.75毫克左炔诺孕酮片和0.75毫克的第二片药片组成（Roye和Johnsen，2002）。它旨在防止发生避孕事故或无保护的性行为后72小时内怀孕。据报道，B计划比其他EC方法（例如Yuzpe方法）更有效，且副作用更少，如果正确使用，则可将妊娠风险降低89％（生育力调节后排卵方法工作组[TFPMFR]，1998年） 。总而言之，看来B计划是当今最有效的EC方法，副作用最少.2006年这项研究开始时，B计划在美国只能通过处方购买，并且具有但阿拉斯加州，加利福尼亚州，夏威夷州，马萨诸塞州，新罕布什尔州，新墨西哥州和华盛顿州除外（Sable，Schwartz，Kelly，Libson和Hall，2006年）。许多国家已经在没有处方的情况下提供了紧急避孕药，包括英国，南非，以色列和法国，但在美国，这种避孕方法仍然仅限于处方药使用（Pentel，Nelson，Wikelius和Cooper，2004年）。在开发期间

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