Next Article in Journal
The Emerging Role of Checkpoint Inhibition in Microsatellite Stable Colorectal Cancer
Previous Article in Journal
Colorectal Cancer Biomarkers in the Era of Personalized Medicine
Article Menu

Export Article

Open AccessReview
J. Pers. Med. 2019, 9(1), 4; https://doi.org/10.3390/jpm9010004

Re-Examining Genetic Screening and Oral Contraceptives: A Patient-Centered Review

1
Department of Economics, Seattle University, 901 12th Avenue, Seattle, WA 98122, USA
2
College of Nursing, Seattle University, 901 12th Avenue, Seattle, WA 98122, USA
*
Author to whom correspondence should be addressed.
Received: 10 November 2018 / Revised: 9 January 2019 / Accepted: 11 January 2019 / Published: 15 January 2019
Full-Text   |   PDF [250 KB, uploaded 15 January 2019]

Abstract

The World Health Organization classifies combined hormonal contraception as an unacceptable health risk in the presence of a known thrombogenic mutation but advises against routine thrombophilia screening before initiating combined oral contraceptives (COCs) on the grounds of high screening costs and low prevalence. From the perspective of patient-centered care, we examine cost, prevalence, and other published arguments for and against thrombophilia screening before initiating COCs. Our patient-centered review draws on relevant empirical evidence concerning the advantages and disadvantages of thrombophilia screening, while placing the discussion in the broader context of evolving attitudes toward genetic testing and a shifting policy landscape that provides many women direct access to COCs and/or thrombophilia screening. Given variation in prior probabilities of thrombophilia, expected exposure to other risk factors for venous thromboembolism, attitudes towards risk, expected reactions to a positive test result, ability to pay, and concerns about genetic discrimination, we conclude that the current one-size-fits-most approach is not consistent with patient-centered care. Instead, we advocate for greater patient and provider education concerning the implications of thrombophilia screening. Moreover, we recommend offering patients optional thrombophilia screening before initiating COCs. View Full-Text
Keywords: thrombophilia screening; genetic screening; combined oral contraceptives; patient-centered care thrombophilia screening; genetic screening; combined oral contraceptives; patient-centered care
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Hiedemann, B.; Vernon, E.; Bowie, B.H. Re-Examining Genetic Screening and Oral Contraceptives: A Patient-Centered Review. J. Pers. Med. 2019, 9, 4.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Pers. Med. EISSN 2075-4426 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top