TY - JOUR T1 - Supporting blood pressure measurement prior to online prescription of the combined oral contraceptive JF - BMJ Sexual & Reproductive Health JO - BMJ Sex Reprod Health SP - 157 LP - 158 DO - 10.1136/bmjsrh-2020-200887 VL - 47 IS - 3 AU - Paula Baraitser AU - Hannah McCulloch AU - Zainab Shather AU - Caroline J Free Y1 - 2021/07/01 UR - http://jfprhc.bmj.com/content/47/3/157.abstract N2 - Online sexual health tests and contraception may improve access to sexual health care.1 2 Online services offer the benefits of increased convenience and control but also require additional responsibilities and resources (time, skills, information) from users3 with associated health risks and benefits. In this editorial we think through strategies to support these new user responsibilities and minimise health risks, using the example of self-reported blood pressure (BP) prior to a prescription of the combined oral contraceptive (COC).International guidelines specify that a BP check is required prior to a prescription of the COC.4 Ethinylestradiol stimulates an increase in hepatic protein production including angiotensinogen with slightly reduced renal blood flow and small BP increases that are clinically significant in 2% of users. BP is therefore monitored before first prescription of the pill and then annually, and the COC is contraindicated if BP is consistently above 140/90 mmHg.4 In face-to-face services, BP is collected and recorded by clinicians prior to prescribing, usually as a single measurement with repeat readings taken if the first reading is high.5 BP is highly variable and errors taking BP are common.6 Large variations in BP measured in office settings in clinical trials and primary care suggest limitations to the accuracy of measurements taken in this way.7 8 The UK Faculty of Sexual and Reproductive Healthcare (FSRH) recommends that remote … ER -