Some ‘Online Firsts’ and News

The following papers have been published at

The financial costs to patients of diagnosing and excluding ectopic pregnancy (Unger et al)

In their article, Unger and his colleagues in Edinburgh report on their assessment of an area of patient experience that is not often considered when assessing medical interventions. The financial impact on patients’ lives of the need to seek medical attention can be considerable and may become more significant as economic hardship increases. This paper describes a well-conducted questionnaire study on the costs that patients themselves incurred in attending their general practitioners and a hospital clinic with a suspected ectopic pregnancy. The authors argue that such costs need to be factored into decisions regarding the cost-effectiveness of medical procedures. from David Horwell, Advisory Editor

Despite the best intentions: a reflection on low client numbers for a pilot telemedicine sexual health service (Garrett & Kirkman)

This “Better Way of Working” article describes the outcome of a pilot of a telemedicine sexual health service for rural youth in Victoria, Australia. Despite expecting high client numbers, few used the service. This article explores the reasons for the disappointing usage, and concludes that clinicians’ expertise and passion for improving access to health care may not be enough to guarantee successful design and implementation of the most appropriate service. from Gillian RobinsonAssociate Editor

Uptake and continuation rates of the intrauterine system in a university student general practice population in the UK (Armitage et al)

This is a very simple real-life observational study of a cohort of young nulliparous women in a university-based general practice choosing and continuing with LARCs as their first line method of contraception. This paper compels the reader to offer this ‘fit and forget’ method of contraceptive to our younger population, of course along with all other forms of contraception, as a matter of routine. from Scott Wilkes, Associate Editor

Removal of a fractured Nexplanon® (Elliman)

In a letter to the editor Alyson Elliman describes removal of a partially fractured, curved implant with no obvious cause and asks if other clinicians have observed anything similar.

NICE Good Practice Guidance: Patient Group Directions is now under development.

This guidance is now in development and due to be published in April 2013

Stakeholder registration is now open.  To register your organisation as a stakeholder* send registration details (name of contact, name of organisation, email address) to using the subject heading Patient group directions GPG stakeholder registration 2012/13

*for the purposes of this guidance stakeholders are:

  • national patient and carer organisations that directly or indirectly represent the interests of people whose care is covered by the guidance
  • national organisations that represent the healthcare professionals who provide the services described in the guidance
  • companies that manufacture the medicines or devices used in the area covered by the guidance and whose interests may be significantly affected by the guidance
  • providers and commissioners of health services in England, Wales and Northern Ireland
  • statutory organisations including the Department of Health, the Welsh Assembly Government, NHS Quality Improvement Scotland, the Healthcare Commission and the National Patient Safety Agency
  • research organisations that have done nationally recognised research in the area

See for further information.

Philippine Government finally passes Reproductive Health Bill after 14 years.

This is a huge victory in the Philippines for access to maternal health services, family planning, and sex education. The reproductive health bill gives the national government the mandate to make reproductive health services accessible to poor families through information and education and the provision of free contraceptives.



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