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Community pharmacists providing emergency contraception give little advice about future contraceptive use: a mystery
Anna Glasier1, Rachel Manners, Joanna C Loudon
1NHS Lothian Family Planning and Well Woman Services, 18 Dean Terrace, Edinburgh, EH4 1NL Scotland, UK. anna.glasier@ed.ac.uk
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.
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