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Supporting blood pressure measurement prior to online prescription of the combined oral contraceptive
BMJ Sexual & Reproductive Health ( IF 3.4 ) Pub Date : 2021-07-01 , DOI: 10.1136/bmjsrh-2020-200887
Paula Baraitser 1 , Hannah McCulloch 2 , Zainab Shather 2 , Caroline J Free 3
Affiliation  

Online sexual health tests and contraception may improve access to sexual health care.1 2 Online services offer the benefits of increased convenience and control but also require additional responsibilities and resources (time, skills, information) from users3 with associated health risks and benefits. In this editorial we think through strategies to support these new user responsibilities and minimise health risks, using the example of self-reported blood pressure (BP) prior to a prescription of the combined oral contraceptive (COC). International guidelines specify that a BP check is required prior to a prescription of the COC.4 Ethinylestradiol stimulates an increase in hepatic protein production including angiotensinogen with slightly reduced renal blood flow and small BP increases that are clinically significant in 2% of users. BP is therefore monitored before first prescription of the pill and then annually, and the COC is contraindicated if BP is consistently above 140/90 mmHg.4 In face-to-face services, BP is collected and recorded by clinicians prior to prescribing, usually as a single measurement with repeat readings taken if the first reading is high.5 BP is highly variable and errors taking BP are common.6 Large variations in BP measured in office settings in clinical trials and primary care suggest limitations to the accuracy of measurements taken in this way.7 8 The UK Faculty of Sexual and Reproductive Healthcare (FSRH) recommends that remote …

中文翻译:

在复方口服避孕药的在线处方之前支持血压测量

在线性健康测试和避孕可能会改善获得性健康护理的机会。1 2 在线服务提供了更多便利和控制的好处,但也需要用户 3 承担额外的责任和资源(时间、技能、信息),以及相关的健康风险和好处。在这篇社论中,我们以处方复方口服避孕药 (COC) 之前自我报告的血压 (BP) 为例,考虑了支持这些新用户责任和最大程度降低健康风险的策略。国际指南规定,在开具 COC 处方之前需要进行血压检查。4 炔雌醇会刺激肝脏蛋白质产生的增加,包括血管紧张素原,肾血流量略有减少,血压略有增加,2% 的使用者具有临床意义。
更新日期:2021-07-12
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