Emergency hormonal contraception (EHC) became available for purchase from pharmacies in January 2001. The aim behind the deregulation of EHC was to improve access and minimize the delay in starting treatment. Guidelines and training for pharmacists supplying EHC aimed to ensure best practice and a high level of patient care.¹ Prior to the deregulation, pharmacists had expressed a range of views both in support of and against the deregulation of EHC.² The aim of this study was to examine pharmacists' views on and experience with EHC one year after the OTC product was made available.

Method

A questionnaire was designed utilising closed and scaled questions and attitudinal statements. It covered pharmacist issues and experience supplying EHC. The questionnaire was posted to 374 pharmacies in Essex using the Yellow Pages as a database for addresses. A covering letter explained the purpose of the study and a stamped addressed envelope was included for return of the questionnaire. The first mailing was in March 2002, followed by a second mailing four weeks later. Data were entered into Excel and analysed using SPSS.

Results

The total number of completed questionnaires was 217 (161 first and 56 second mailing) which is a response rate of 58%. A high percentage (79%) of all pharmacies had requests for EHC between 1-5 times per week, while multiple pharmacies were frequently supplying >6. Pharmacists responded positively to the attitudinal statements, e.g. 88% considered it was important for pharmacies to offer this service. Most pharmacists (60%) spent between 5-10 minutes on each patient, although almost a third (n=63) spent less than 5 minutes. Advice on contraception and sexually transmitted diseases (STDs) was rarely or never given by 28% and 65% of pharmacists respectively. Some pharmacists (16%) reported having requests for EHC for later use and 22% had requests for EHC from the same woman on more than one occasion. Type of pharmacy did not significantly (P<0.05) affect these requests. The majority of pharmacists (76%) has refused a supply and the main reasons for this were that the patient was or appeared to be under 16 years old or the request was made by a third party. Few pharmacists (3.5%) reported having difficulties complying with the RSPGB guidance on supply of EHC with under age requests being the primary concern.

Discussion

Demand for the EHC service was apparent in the numbers supplied per week. Pharmacists support for the service was also clearly evident. It would appear that opportunities for education on contraception and STDs were being missed. Increases in the latter are a major cause for concern and at the very least, leaflets about STDs and contraception could be included with the product supplied. Levels of abuse are difficult to quantify. However, it is also encouraging that almost all pharmacists were able to comply with RSPGB guidelines.

References

1. Anon. 2000 Pharm J 265; 546.

2. D'Souza R & Bounds W. 2001 Pharm J 266;293-6.