scholarly journals Emergency Contraception Counseling in California Community Pharmacies: A Mystery Caller Study

Pharmacy ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 38 ◽  
Author(s):  
Ditmars ◽  
Rafie ◽  
Kashou ◽  
Cleland ◽  
Bayer ◽  
...  
Keyword(s):  
San Francisco ◽  
Emergency Contraception ◽  
San Diego ◽  
Intrauterine Device ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Ulipristal Acetate ◽  
Contraception Counseling ◽  
Copper Intrauterine Device

This study was conducted to determine which emergency contraception (EC) methods are offered by community pharmacists in response to patient calls. Female mystery callers called all community pharmacies in two California cities using standardized scripts. The callers inquired about options available to prevent pregnancy after sex and whether that method was available at the pharmacy, using follow-up probes if necessary. A total of 239 calls were completed in San Diego (n = 127, 53%) and San Francisco (n = 112, 47%). Pharmacists indicated availability at most sites (n = 220, 92%) with option(s) reported as levonorgestrel only (LNG; n = 211, 88.3%), both ulipristal acetate (UPA) and LNG (n = 4, 1.6%), UPA only (n = 1, 0.4%), or non-specific EC (n = 4, 1.7%). Nineteen pharmacies (7.9%) did not have EC available on the day of the call. Following additional probing, some pharmacists discussed UPA (n = 49, 20.5%) or the copper intrauterine device (n = 1, 0.4%) as EC options. LNG EC products were available same-day in 90.1% of pharmacies, whereas UPA was available same-day in 9.6% of pharmacies. The majority of pharmacies called in this study offered and stocked at least one EC option, but the focus of discussions was on LNG and matched what was in stock and available.

scholarly journals Emergency Oral Contraceptive Consultations in Pharmacies in a Rural Setting: An Epidemiological Analysis

2020 ◽  
pp. 089719002096169
Author(s):  
Emma Pearce ◽  
Kate Jolly
Keyword(s):  
Emergency Contraception ◽  
Intrauterine Device ◽  
Rural Setting ◽  
Chlamydia Screening ◽  
Unprotected Sexual Intercourse ◽  
Epidemiological Analysis ◽  
Ulipristal Acetate ◽  
Age Appropriate ◽  
Pharmacy Setting ◽  
Copper Intrauterine Device

Background: Emergency contraception has been available in pharmacies across England since 2001.There is a paucity of evidence describing those women accessing the service, particularly in rural locations, where pharmacies are integral to improving healthcare accessibility. Methods: Routinely collected data from all pharmacy consultations for emergency contraception in Shropshire, England, were obtained and anonymized for the study period April 1, 2016 to January 31, 2019. Consultations were described by time, age of consultee, rationale for consultation, method dispensed (levonorgestrel or ulipristal acetate), referral for copper intrauterine device fitting, chlamydia screening where appropriate and reason for choosing pharmacy setting. Repeat attenders were also described separately. Results: 3499 consultations occurred during the study period; 39% were aged between 16-20 years, and 52% attended following unprotected sexual intercourse. Levonorgestrel was initially most prescribed, however ulipristal acetate overtook it in 2018. Onward referral for copper intrauterine device and age-appropriate chlamydia screening took place in 3% and 4% of the eligible populations respectively. Women overwhelmingly chose the pharmacy setting owing to its convenience. Repeat attenders tended to be younger than single attenders, but otherwise similar. Conclusion: Pharmacy-based emergency contraception is an important and well-utilized service in this rural location and continued funding and possible service expansion should be considered.

scholarly journals Emerging Options for Emergency Contraception

2013 ◽  
Vol 7 ◽  
pp. CMRH.S8145 ◽  
Author(s):  
Atsuko Koyama ◽  
Laura Hagopian ◽  
Judith Linden
Keyword(s):  
Emergency Contraception ◽  
Intrauterine Device ◽  
Over The Counter ◽  
Oral Contraceptive Pills ◽  
Ulipristal Acetate ◽  
Emergency Contraceptive Pills ◽  
Contraceptive Pills ◽  
Emergency Contraceptive ◽  
Clinical Considerations ◽  
Copper Intrauterine Device

Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference.

scholarly journals Intrauterine Device Insertion during Cesarean Section in Women without Prenatal Contraception Counseling: Lessons from a Country with High Cesarean Rates

2019 ◽  
Vol 41 (08) ◽  
pp. 485-492
Author(s):  
Alberto Moreno Zaconeta ◽  
Ana Carolina Oliveira ◽  
Flavielly Souza Estrela ◽  
Thalia Maia Vasconcelos ◽  
Paulo Sergio França ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Removal Rate ◽  
Intrauterine Device ◽  
Uterine Perforation ◽  
Cesarean Sections ◽  
Trial Of Labor ◽  
The Moment ◽  
Contraception Counseling

Objective The moment of admission for delivery may be inappropriate for offering an intrauterine device (IUD) to women without prenatal contraception counseling. However, in countries with high cesarean rates and deficient prenatal contraception counseling, this strategy may reduce unexpected pregnancies and repeated cesarean sections. Methods This was a prospective cohort study involving 100 women without prenatal contraception counseling. Postplacental IUD was offered after admission for delivery and placed during cesarean. The rates of IUD continuation, uterine perforation, and endometritis were assessed at 6 weeks and 6 months, and the proportion of women continuing with IUD at 6 months was assessed with respect to the number of previous cesareans. Results Ninety-seven women completed the follow-up. The rate of IUD continuation was 91% at 6 weeks and 83.5% at 6 months. The expulsion/removal rate in the first 6 weeks was not different from that between 6 weeks and 6 months (9 vs 9.1%, respectively). There were 2 cases of endometritis (2.1%), and no case of uterine perforation. Among 81 women continuing with intrauterine device after 6-months, 31% had undergone only the cesarean section in which the IUD was inserted, 44% had undergone 2 and 25% had undergone 3 or more cesarean sections. Conclusion Two thirds of the women who continued with IUD at 6 months had undergone 2 or more cesarean sections. Since offering trial of labor is unusual after 2 or more previous cesareans, we believe that offering IUD after admission for delivery may reduce the risk of repeated cesarean sections and its inherent risks.

scholarly journals Emergency Contraception Access and Counseling in Urban Pharmacies: A Comparison between States with and without Pharmacist Prescribing

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 105 ◽  
Author(s):  
Rebecca H. Stone ◽  
Sally Rafie ◽  
Dennia Ernest ◽  
Brielle Scutt
Keyword(s):  
Continuing Education ◽  
San Francisco ◽  
Emergency Contraception ◽  
Primary Source ◽  
Community Pharmacies ◽  
Patient Access ◽  
Patient Counseling ◽  
The Public ◽  
Adult Females ◽  
Primary Endpoints

Pharmacists are often the primary source of emergency contraception (EC) access and patient information. This study aims to identify differences in pharmacist-reported EC access and counseling between states which do or do not permit pharmacist-prescribed EC. This prospective, mystery caller study was completed in California (CA), which permits pharmacist-prescribed EC after completion of continuing education, and Georgia (GA), which does not. All community pharmacies that were open to the public in San Diego and San Francisco, CA, and Atlanta, GA were called by researchers who posed as adult females inquiring about EC via a structured script. Primary endpoints were EC availability and counseling. Statistical analyses completed with SPSS. Researchers called 395 pharmacies, 98.2% were reached and included. Regarding levonorgestrel (LNG), CA pharmacists more frequently discussed (CA 90.4% vs. GA 81.2%, p = 0.02), stocked (CA 89.5% vs. GA 67.8%, p < 0.01), and correctly indicated it “will work” or “will work but may be less effective” 4 days after intercourse (CA 67.5% vs. GA 17.5%, p < 0.01). Ulipristal was infrequently discussed (CA 22.6% vs. GA 3.4%, p < 0.01) and rarely stocked (CA 9.6% vs. GA 0.7%, p < 0.01). Pharmacists practicing in states which permit pharmacist-prescribed EC with completion of required continuing education may be associated with improved patient access to oral EC and more accurate patient counseling.

Sign in / Sign up

Export Citation Format

Share Document