CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Contraception is a significant concern for Canadian women of child-bearing age, their partners and their health care providers. In this narrative review we provide information on current trends and recent changes in Canadians' choices of contraceptive methods. We review the characteristics of contraceptive methods available in Canada, with an emphasis on hormonal methods and newer options such as the transdermal contraceptive patch, the vaginal contraceptive ring and the levonorgestrel-releasing intrauterine system. We also discuss adherence to contraception as well as approaches to counselling to promote adherence and to reduce the risk of sexually transmitted infections in the context of contraception.
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A principal objective of the Canadian Clinical Practice Guidelines for the Care and Treatment of Breast Cancer was to reduce the variation in the way that breast cancer was being treated. To evaluate whether this goal has been reached, we examined variations among surgeons for 4 measures of surgical care and tested for differences in province-wide rates and in variations among surgeons before and after the guidelines were released. ⋯ Our results suggest that the Canadian breast cancer guidelines are not meeting their stated objective. New strategies for guideline dissemination and implementation may be required.