Current Resources for Evidence-Based Practice, July/August 2010: Current Resources for Evidence-Based Practice, July/August 2010

In April 2008, the World Health Organization (WHO) convened a panel of experts to review evidence and update global guidance for family planning. Eighty-six new recommendations and 165 revisions to existing guidelines are included in the updated documents, Medical Eligibility Criteria for Contraceptive Use, 4th edition, released in November, 2009 (World Health Organization, 2009), and Selected Practice Recommendations for Contraceptive Use, 2nd edition, 2008 update (World Health Organization, 2004, 2008). The first document discusses use of specific contraceptive methods in women with underlying diseases, conditions, and characteristics, while the second details clinical management for various contraceptive methods. To update these resources, new primary evidence was identified and appraised using the US Preventive Services Task Force grading system, and systematic reviews were conducted using the MOOSE (Meta-analysis of Observational Studies in Epidemiology) and QUOROM (Quality of Reporting of Meta-analyses) reporting tools. The new eligibility criteria include recommendations regarding postpartum IUD use, as well as criteria for contraceptive use in women with lupus, deep vein thrombosis or pulmonary embolism, and viral hepatitis; adolescents who are obese; and women taking antiviral and antimicrobial agents. Updated management guidelines cover missed oral contraceptive pills, as well as timing of repeat progestogen-only injectables and management of bleeding for women using them. Nine systematic reviews that formed the basis of many of these recommendations were published in the October 2009 issue of the journal Contraception (Contraception, 2009).