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Contraception. 2014 Oct;90(4):447-53. doi: 10.1016/j.contraception.2014.05.004. Epub 2014 May 14.

Pharmacy-based interventions for initiating effective contraception following the use of emergency contraception: a pilot study.

Author information

1
Department of Reproductive and Developmental Sciences, University of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 5SU, United Kingdom; Chalmers Sexual Health Centre, 2A Chalmers Street, Edinburgh, EH3 9ES, United Kingdom. Electronic address: michieluc@yahoo.co.uk.
2
Department of Reproductive and Developmental Sciences, University of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 5SU, United Kingdom; Chalmers Sexual Health Centre, 2A Chalmers Street, Edinburgh, EH3 9ES, United Kingdom.
3
Department of Reproductive and Developmental Sciences, University of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 5SU, United Kingdom; London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom.
4
London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom.
5
Department of Public Health and Health Policy, NHS Lothian, Waverley Gate, 2-4 Waterloo Place, Edinburgh, EH1 3EG.
6
Pharmacy Department, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh, EH10 5HF.

Abstract

OBJECTIVES:

In Scotland most women get emergency contraception (EC) from pharmacies. Pharmacists currently cannot provide effective ongoing contraception after EC. In this pilot study, we aimed to determine the feasibility of a larger study designed to ascertain if pharmacy-based interventions can increase the uptake of effective contraception after EC.

STUDY DESIGN:

This is a pilot study of women presenting for levonorgestrel EC to community pharmacies in Edinburgh, UK, in 2012. Pharmacies were cluster randomized to provide either standard care or one of two interventions: (a) one packet of progestogen-only pills (POPs), giving women 1 month to arrange ongoing contraception; (b) invitation to present the empty EC packet to a family planning clinic (FPC) for contraceptive advice (rapid access).

RESULTS:

One hundred sixty-eight women were recruited from 11 pharmacies to POP (n=56), rapid access (n=58) and standard care (N=54) groups, respectively. Telephone follow-up was conducted successfully in 102 women (61%) 6-8 weeks later to determine current contraceptive use. In the POP arm, 35/39 (90%) women used the pills provided, and 9/28 women (32%) in the rapid access arm attended the FPC. The proportion of women using effective contraception at follow-up was significantly greater in both POP [56% (22/39), p=<0.001] and rapid access [52% (13/25), p=0.006] groups compared to standard care [16% (5/31)]. The relative probability of a woman using an effective method of contraception versus barrier/no method, after use of EC, was 3.13 [95% confidence interval (CI), 1.90-5.13] in the POP group and 2.57 (95% CI, 1.55-4.27) in the rapid access group.

CONCLUSIONS:

This promising pilot study suggests that simple pharmacy-based interventions may increase the uptake of effective contraception after EC. A larger study is required to provide further validation of these findings.

IMPLICATIONS STATEMENT:

For women obtaining EC from a pharmacy, simple interventions such as supplying 1 month of a POP, or offering rapid access to a FPC, hold promise as strategies to increase the uptake of effective contraception after EC.

KEYWORDS:

LARC; Levonelle; Morning-after pill; POP; Quick-start

[Indexed for MEDLINE]

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