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The latest evidence for practice

Choice picks from the research journals, with some choice comment …

Una Adderley
Community Tissue
Viability Prescribing

Does advance provision of emergency contraception reduce unplanned pregnancies?

The advance provision of emergency contraception has raised concerns that this practice may decrease the use of more reliable contraceptive methods and encourage risky sexual behaviour, which increases the risk of sexually transmitted diseases.
This Cochrane systematic review examined the results of eight randomised controlled trials published in English that had compared the provision of advance emergency contraception with another intervention such as counselling, information about emergency contraception, or provision of emergency contraception on request to a clinic or pharmacy. The review found that although advance provision increased the use of emergency contraception and shortened the time between unprotected intercourse and the use of emergency contraception, there was no difference between the groups in terms of pregnancy rates, levels of sexually transmitted disease, unprotected intercourse or use of condoms. 
A commentary notes that this review provides reassuring information about the apparent lack of harm in relation to condom use and the incidence of sexually
transmitted disease. However, they also note that it does raise concern about the behavioural issues surrounding the failure to use emergency contraception, even when it is readily available.

Polis C, Schaffer K, Blanchard K, et al. Advance provision of emergency contraception for pregnancy prevention. Cochrane Database Syst Rev 2007;(2):CD005497.

Quinn S. Evid Based Nurs 2007;10:106.

Is soft drink consumption linked to increased risk of chronic disease?

The consumption of soft drinks has steadily increased over recent years and many clinicians have concerns as to the possible adverse effects this increased consumption may have on long-term health.
This American review examined the results of 88 cross-sectional studies, longitudinal studies and randomised controlled trials that assessed the relationship between soft drink consumption and energy intake, body weight, milk intake and calcium intake.
Nutrition and health were assessed as secondary outcomes. The review found that soft drink consumption is associated with increased energy intake and body weight, reduced milk and calcium intake, and consequently recommends that clinicians should encourage patients overall to reduce soft drink consumption.
A commentary notes that this review adds to the knowledge base regarding the negative effects of soft drink consumption on nutrition and health although the findings regarding nutrient intake and specific chronic diseases are limited by the small number of included studies. However, they argue that most clinicians would agree that the findings suggest that the benefits of limiting soft drink consumption outweigh the risks and therefore this review provides evidence to recommend limiting soft drink consumption to their clients.

Vartanian LR, Schwartz MB, Brownell KD. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Am J Public Health 2007;97:667-75.

Yost J. Evid Based Nurs 2007;10:120.