最新情報：Providing Quality Family Planning Services ― CDCおよびアメリカのOffice of Population Affairsからの勧告、2015年

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ホーム IMICライブラリ MMWR抄訳 2016年（Vol.65)最新情報：Providing Quality Fa･･･

MMWR抄訳

2016/03/11Vol. 65 / No. 9

MMWR65(9):231－234
Update: Providing Quality Family Planning Services — Recommendations from CDC and the U.S. Office of Population Affairs, 2015

最新情報：Providing Quality Family Planning Services ― CDCおよびアメリカのOffice of Population Affairsからの勧告、2015年

2014年にCDCは、家族計画の受診において提供されるべきサービスおよびそれらのサービスをどのように提供するかに焦点をあてた「Providing Quality Family Planning Services―CDCおよびアメリカのOffice of Population Affairs(OPA)から提言(QFP)」を発表した。QFPのセクションには、避妊の提供、妊娠テストおよびカウンセリング、妊娠を希望する患者、基本的な不妊治療、受胎前の健康状態の診療、性感染症(STD)の診療、関連する予防衛生サービス、エビデンスでは支持されていないスクリーニングのためのスクリーニングサービスが含まれる。CDCとOPAは、出版されているエビデンスの広範囲のレビュー、専門家の意見の探索、CDC、U.S. Preventive Services Task Force(USPSTF)、米国産科婦人科学会および米国小児科学会のような専門家の医師会からの現存する臨床的な勧告の合成により、QFPの勧告を作成している。今回、2014年4月に発表されたQFPからの勧告の2015年末までの最新情報をまとめた。受胎前の健康状態の診療では、血圧に関して、 2015年ではUSPSTFは2007年の勧告を再確認し、高血圧のスクリーニングを日常的におこなうことを推奨し、診察室での血圧測定のやり方の説明および診療状況外での高血圧診断の確認の必要性を述べている。糖尿病に関し、2015年の改定では、40～70歳の過体重または肥満女性への糖尿病スクリーニングおよび異常血糖値の患者への積極的な行動カウンセリングの介入を推奨した。STDに関し、CDCはSTD治療のガイドラインを変更し、クラミジア検査対象年齢のカットオフ値を25歳以下から25歳未満へと変更し、ヒト免疫不全ウイルス(HIV)感染者での毎年1回以上のC型肝炎検査、性転換患者での現在の生体構造および性行動に基づいたSTDおよびHIVに関連したリスクの評価、淋病および陰部疣贅を含むいくつかのSTDの代替療法を推奨した。また、CDCは HIVの成人および青年のためのHIV予防に対する新規のガイダンスを提供した。エビデンスでは支持されていないスクリーニングに関し、2014年の勧告では男性のクラミジアおよび淋病のスクリーニングに十分なエビデンスがなかったが、2015年ではリスクのある男性のスクリーニングが推奨された。アメリカでは、B型肝炎ウイルス感染の有病率は低いため、リスクの低い患者でのスクリーニングは推奨されない。

References

Updated Reference List, By QFP Section

Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and the US Office of Population Affairs. MMWR Recomm Rep 2014;63(No. RR-04).

Contraceptive Services

American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. Increasing access to contraceptive implants and intrauterine devices to reduce unintended pregnancy. Committee Opinion No. 642; October 2015. ＜http://www.acog.org/-/media/Committee-Opinions/Committee-on-Gynecologic-Practice/co642.pdf?dmc=1＞
Ott MA, Sucato GS; Committee on Adolescence. Contraception for adolescents. Pediatrics 2014;134:e1257–81. ＜http://dx.doi.org/10.1542/peds.2014-2300＞

Pregnancy Testing and Counseling

American College of Obstetricians and Gynecologists. Guidelines for perinatal care. 7th ed. Washington, DC: American Academy of Pediatrics and the American College of Obstetricians and Gynecologists; 2012.
American College of Obstetricians and Gynecologists. Guidelines for women’s health care: a resource manual, 4th ed. Washington, DC: American College of Obstetricians and Gynecologists; 2014.

Clients Who Want to Become Pregnant

Practice Committee of American Society for Reproductive Medicine in collaboration with Society for Reproductive Endocrinology and Infertility. Optimizing natural fertility: a committee opinion. Fertil Steril 2013;100:631–7. ＜http://dx.doi.org/10.1016/j.fertnstert.2013.07.011＞

Basic Infertility Services

Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril 2015;103:e44–50. ＜http://dx.doi.org/10.1016/j.fertnstert.2015.03.019＞

Preconception Health Services

Kim DK, Bridges CB, Harriman KH; Advisory Committee on Immunization Practices (ACIP). Advisory committee on immunization practices recommended immunization schedule for adults aged 19 years or older—United States, 2015. MMWR Morb Mortal Wkly Rep 2015;64:91–2.
Strikas RA; Advisory Committee on Immunization Practices (ACIP). Advisory committee on immunization practices recommended immunization schedules for persons aged 0 through 18 years—United States, 2015. MMWR Morb Mortal Wkly Rep 2015;64:93–4.
US Preventive Services Task Force. Drug use, illicit: primary care interventions for children and adolescents. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2014. ＜http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/drug-use-illicit-primary-care-interventions-for-children-and-adolescents＞
US Preventive Services Task Force. Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2015. ＜http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions＞
US Preventive Services Task Force. Screening for abnormal blood glucose and type 2 diabetes mellitus. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2015. ＜http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/screening-for-abnormal-blood-glucose-and-type-2-diabetes＞
US Preventive Services Task Force. Screening for high blood pressure in adults. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2015. ＜http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/high-blood-pressure-in-adults-screening＞

Sexually Transmitted Disease Services

CDC; Health Resources and Services Administration; National Institutes of Health. Recommendations for HIV prevention with adults and adolescents with HIV in the United States, 2014. Atlanta, GA: CDC; 2014. ＜http://stacks.cdc.gov/view/cdc/26062＞
Markowitz LE, Dunne EF, Saraiya M, et al. Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2014;63(No. RR-05).
US Preventive Services Task Force. Behavioral counseling interventions to prevent sexually transmitted infections. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2014. ＜http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/sexually-transmitted-infections-behavioral-counseling1＞
US Preventive Services Task Force. Screening for chlamydia and gonorrhea. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2014. ＜http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/chlamydia-and-gonorrhea-screening＞
Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015;64(No. RR-03).

Screening Services for Which Evidence Does Not Support Screening

US Preventive Services Task Force. Screening for chlamydia and gonorrhea. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2014. ＜http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/chlamydia-and-gonorrhea-screening＞
US Preventive Services Task Force. Screening for hepatitis B infection in nonpregnant adolescents and adults. Rockville, MD: US Department of Health and Human Services, Agency for Healthcare Research and Quality; 2014. ＜http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/hepatitis-b-virus-infection-screening-2014＞