Karen Wong1, Susan Hum2, Lisa McCarthy3, Sheila Dunn4. 1. Faculty of Medicine, University of Toronto, Toronto, ON. 2. Women's College Research Institute, Women's College Hospital, Toronto, ON. 3. Women's College Research Institute, Women's College Hospital, Toronto, ON; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON; Department of Family and Community Medicine, University of Toronto, Toronto, ON. 4. Women's College Research Institute, Women's College Hospital, Toronto, ON; Department of Family and Community Medicine, University of Toronto, Toronto, ON; Dalla Lana School of Public Health, University of Toronto, Toronto, ON. Electronic address: Sheila.dunn@wchospital.ca.
Abstract
OBJECTIVE: Pharmacists are often the front-line health care providers for women seeking emergency contraception (EC). This study explored Ontario pharmacists' EC counselling practices and their perceived barriers to recommending the most effective EC method, the copper IUD (Cu-IUD). METHODS: This qualitative study used one-on-one, semistructured interviews with 20 pharmacists working in pharmacies located within a 1-km radius of a large sexual health clinic that offered postcoital IUDs in downtown Toronto. RESULTS: All pharmacists provided counselling about levonorgestrel (LNG-EC), and all considered it important. Nevertheless, they rarely discussed the Cu-IUD, even in circumstances where LNG-EC could be less effective, such as delayed presentation or for women with BMI >25 kg/m2. Some pharmacists felt conflicted in their dual roles as health care and customer service provider when counselling about and selling EC, and many felt uncomfortable discussing body weight. Pharmacists were not well informed about the Cu-IUD. They identified many pharmacist-specific barriers to counselling about the Cu-IUD for EC, as well as health systems issues around Cu-IUD provision and insertion. CONCLUSION: Ontario pharmacists embraced their role in EC counselling, yet their discussions rarely included the most effective Cu-IUD option. Educating and training pharmacists about the Cu-IUD and establishing referral pathways for IUD insertion could expand their counselling about this EC option.
OBJECTIVE: Pharmacists are often the front-line health care providers for women seeking emergency contraception (EC). This study explored Ontario pharmacists' EC counselling practices and their perceived barriers to recommending the most effective EC method, the copper IUD (Cu-IUD). METHODS: This qualitative study used one-on-one, semistructured interviews with 20 pharmacists working in pharmacies located within a 1-km radius of a large sexual health clinic that offered postcoital IUDs in downtown Toronto. RESULTS: All pharmacists provided counselling about levonorgestrel (LNG-EC), and all considered it important. Nevertheless, they rarely discussed the Cu-IUD, even in circumstances where LNG-EC could be less effective, such as delayed presentation or for women with BMI >25 kg/m2. Some pharmacists felt conflicted in their dual roles as health care and customer service provider when counselling about and selling EC, and many felt uncomfortable discussing body weight. Pharmacists were not well informed about the Cu-IUD. They identified many pharmacist-specific barriers to counselling about the Cu-IUD for EC, as well as health systems issues around Cu-IUD provision and insertion. CONCLUSION: Ontario pharmacists embraced their role in EC counselling, yet their discussions rarely included the most effective Cu-IUD option. Educating and training pharmacists about the Cu-IUD and establishing referral pathways for IUD insertion could expand their counselling about this EC option.
Authors: Michelle C Chan; Sarah Munro; Laura Schummers; Arianne Albert; Frannie Mackenzie; Judith A Soon; Parkash Ragsdale; Brian Fitzsimmons; Regina Renner Journal: CMAJ Open Date: 2021-11-30
Authors: Sarah Munro; Kate Wahl; Judith A Soon; Edith Guilbert; Elizabeth S Wilcox; Genevieve Leduc-Robert; Nadra Ansari; Courtney Devane; Wendy V Norman Journal: Implement Sci Date: 2021-08-03 Impact factor: 7.327