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    029324

    Response of patients and doctors to the 1983 'pill scare'.

    Ritchie LD Berkeley MI

    Journal of the Royal College of General Practitioners. 1984 Nov; 34(268):600-2.

    The immediate responses of physicians and patients to adverse publicity about the possibility of cancer among women using combined oral contraceptives (OCs) were studied in 2 separate locations: the main family planning clinic in the city of Aberdeen, and a provincial general practice of 10 doctors based in the Peterhead Health Centre. A press release was issued 1 day prior to publication of 2 articles in the Lancet of 22 October 1983, reporting possible risks of breast and cervical cancer in some patients on combined OCs. For the 20 workdays immediately after publication, the 16 participating doctors at both locations collected survey data on the ages of patients and outcomes of consultations for all patients who expressed concern about the OCs. In the family planning clinic, 207 consultations with clinic doctors were prompted by anxiety over the pill and accounted for 24.8% of the workload over the 20 days. In the practice, 73 women (7.8% of all the pill users) who attended over the 20 days expressed concern about OCs. The general practitioners reported lower than expected levels of patient response, whereas the family planning clinic required extra sessions to accomodate the temporary upsurge in demand. At each consultation, the doctor either changed the type of pill, changed the method of contraception, or offered reassurance only. At the family planning clinic and practice respectively, the 1st outcome choices were a change of pills for 58.5% and 39.7% of patients, a change of method for 14.0% and 2.7%, and reassurance only for 27.5% and 57.5%. The mean age of patients was 25.1 years at the family planning clinic and 25.6 years at the health center. This limited study suggests that the predicted "pill scare" did not occur at the Peterhead Health Centre, while in contrast the family planning clinic reported a marked increase in workload including inquiries from the press and local radio stations. Factors accounting for the general practitioners' more conservative responses to patients with pill-related anxiety may have included differences in the type of patient seen; the greater time constraints on the general practitioners, whose patients were booked at 6-minute intervals compared to 12-minute intervals in the clinic; or the continuity of care provided by the general practitioners.
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