BACKGROUND: UK women increasingly prefer to attend a pharmacy for emergency contraception (EC) rather than a doctor. Most women who use EC do not conceive and remain at risk of pregnancy unless they start regular contraception. We undertook a study to evaluate the quality of service provision in community pharmacies in Lothian, Scotland, and to determine what advice is given about contraception after EC use. STUDY DESIGN: Mystery shopper study. RESULTS: EC was unobtainable from 5/40 pharmacies (12.5%), refused because of "contraindications" in 7 (17.5%) and offered in 28 (70%). Most pharmacists appeared nonjudgemental, over 75% asked appropriate questions about eligibility, and over 90% gave appropriate advice about use. EC was universally refused beyond 72 h after sex but universally provided when the date of the last menstrual period was uncertain. Ongoing contraception after EC use was discussed in only 32.5% of all pharmacies and only 43% of those issuing EC. CONCLUSIONS: The quality of consultations for EC in pharmacies is generally good but only a minority discuss ongoing contraception after EC use. The implications for contraceptive use and unintended pregnancy rates are worrying.
BACKGROUND: UK women increasingly prefer to attend a pharmacy for emergency contraception (EC) rather than a doctor. Most women who use EC do not conceive and remain at risk of pregnancy unless they start regular contraception. We undertook a study to evaluate the quality of service provision in community pharmacies in Lothian, Scotland, and to determine what advice is given about contraception after EC use. STUDY DESIGN: Mystery shopper study. RESULTS: EC was unobtainable from 5/40 pharmacies (12.5%), refused because of "contraindications" in 7 (17.5%) and offered in 28 (70%). Most pharmacists appeared nonjudgemental, over 75% asked appropriate questions about eligibility, and over 90% gave appropriate advice about use. EC was universally refused beyond 72 h after sex but universally provided when the date of the last menstrual period was uncertain. Ongoing contraception after EC use was discussed in only 32.5% of all pharmacies and only 43% of those issuing EC. CONCLUSIONS: The quality of consultations for EC in pharmacies is generally good but only a minority discuss ongoing contraception after EC use. The implications for contraceptive use and unintended pregnancy rates are worrying.
Authors: Sharon T Cameron; Anna Glasier; Lisa McDaid; Andrew Radley; Susan Patterson; Paula Baraitser; Judith Stephenson; Richard Gilson; Claire Battison; Kathleen Cowle; Thenmalar Vadiveloo; Anne Johnstone; Alessandra Morelli; Beatriz Goulao; Mark Forrest; Alison McDonald; John Norrie Journal: Health Technol Assess Date: 2021-05 Impact factor: 4.014
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