BackgroundPharmacies are increasingly providing services related to contraception and STIs. Identifying pharmacy staff’ and users’ experiences and attitudes relating to sexual health services is critical to understand users’ needs and examining how pharmacy staff can most effectively contribute to patient-centred care. This systematic review aimed to examine pharmacy staff and pharmacy users’ experiences and attitudes towards the delivery of a large range of sexual health services.MethodsSeven electronic databases and the reference lists of all included studies were searched in September 2018. Studies giving insight into pharmacy users’ and pharmacy staff’s experiences and attitudes towards the delivery of services related to contraception and STIs were included. The Mixed Methods Appraisal Tool was used to assess the quality of included studies and a narrative synthesis applied to analyse evidence.ResultsNineteen studies were included. Eleven studies looked at pharmacy staff, four at users and four at both groups. Users found services accessible and convenient and staff found service provision feasible. However, several barriers to service delivery were identified including lack of privacy for delivering services, lack of trained staff available to provide services and subjective judgements being made on who should be provided or offered a service.DiscussionBarriers to service delivery need to be addressed to allow pharmacies to deliver their full potential. Future research on pharmacy-based gonorrhoea and syphilis screening, and hepatitis B vaccination is needed.PROSPERO registration numberCRD42018106807.

ObjectivesTo explore the utilisation of pharmacy-based sexual and reproductive health services (SRHS) in order to optimise delivery and identify barriers to access.MethodsThe health provider Umbrella offers six SRHS from over 120 pharmacies in Birmingham (England). In this retrospective study, data collected between August 2015 and August 2018 were used to analyse uptake, user characteristics and attendance patterns according to day of the week.ResultsA total of 60 498 requests for a pharmacy service were included in the analysis. Emergency contraception (50.4%), condoms (33.1%) and STI self-sampling kits (9.6%) accounted for more than 90% of all requests. A lower uptake of services was observed for the contraceptive injection (0.6%), oral contraception (5.4%) and chlamydia treatment (1.0%). Services were most likely to be requested by those self-identifying as female (85.6%), and those aged 16–24 years (53.8%). Based on available ethnicity data (n=54 668), most requests for a service were made by White/White British individuals (43.4%) and Asian/Asian British people (23.1%). The largest number of services were delivered on Mondays (20.9%) and the lowest on Sundays (5.0%). A high proportion of requests for services on Saturdays (57.0%), Sundays (67.6%) and Mondays (54.4%) were made by females presenting for emergency contraception.ConclusionThe evaluation of healthcare utilisation is important to help refine and optimise the delivery of services. However, information relating to pharmacy-based SRHS is scarce and often limited to a single type of service provision. Overall, a wide range of pharmacy-based services were accessed by a diverse range of people, suggesting that pharmacies are a suitable provider of many SRHS. However, the routinely collected data analysed in the study had several limitations restricting the analysis. Sexual health providers should ensure they collect data which are as comprehensive as is possible in order to help understand the utilisation of services.

Background: There is an increasing demand for mental health support in primary care, especially for young people. To improve mental health support for young people in general practice (GP), the needs of young people must be considered. Aim: To explore the experiences of young people (aged 12-25) on receiving mental health care in general practice and identify the needs of young people who present for mental health concerns. Design and Setting: A systematic review and narrative synthesis. Method: Six databases were searched for literature relating to young people’s experiences of receiving mental health care in general practice. Additional handsearching and manual internet searching were conducted. Narrative synthesis was employed. Results: Five studies and a further two reports from manual internet searching were included for synthesis. The synthesis generated four themes: the centrality of a trusting relationship; showing empathy and taking concerns seriously; providing time to talk; and reducing barriers to accessing primary care mental health support. Conclusion: To enable high-quality and effective mental health consultations with young people and the development of trust, GPs require unhurried consultations, and the ability to maintain continuity of care.

Objectives: Review evidence is lacking about how contraception is affected by severe social disruption, such as that caused by the COVID-19 pandemic. The purpose of this scoping review was to explore the impact of natural and man-made disasters on contraception in OECD member countries. Methods: Manual searches and systematic searches in six electronic databases were conducted with no language restrictions. All articles were screened by at least two researchers. The data were analysed thematically. Results: 108 articles were included. Most focussed on the Zika virus outbreak (n ¼ 50) and the COVID-19 pandemic (n ¼ 28). Four key themes were identified: importance of contraception during disasters, impact of disasters on contraceptive behaviour, barriers to contraception during disasters and ways of improving use of contraception during disasters. Despite efforts to increase access to contraception including by transforming ways of delivery, barriers to use meant that unmet need persisted. Conclusions: To prevent adverse health outcomes and reduce health costs as a result of failure to have access to contraception during disasters, there is a need to intensify efforts to remove barriers to use. This should include increasing access and information on methods of contraception and their side effects (e.g., menstrual suppression) and making contraception freely available.

Since August 2015, a large range of sexual health and reproductive health services have been provided in more than 120 pharmacies across Birmingham (England). Our study aimed to explore how pharmacy staff and pharmacy users experience delivering or being provided with sexual health and reproductive health services. Between March and September 2019, semi-structured interviews were conducted with 15 pharmacy staff delivering sexual and reproductive health services and 15 people who had used a sexual and reproductive health service at the pharmacy. Interviews were analysed thematically. Pharmacy users found services convenient to use and were largely satisfied with pharmacy staff consultation skills. Staff were motivated to deliver the services, although some felt that they did not receive sufficient recognition for their work. Barriers to pharmacy-based sexual and reproductive health services were identified, including lack of privacy for users, lack of staff and user awareness of the services, lack of trained staff to deliver services and lack of capacity for copper coil insertions in females presenting for emergency contraception. The identification of barriers to effective service provision can be used to improve the delivery of sexual and reproductive health services in pharmacies and lead to a greater uptake.

The health provider Umbrella delivers several SRHS through more than 120 pharmacies in Birmingham (England). Umbrella pharmacy data collected between August 2015 and August 2018 were used to descriptively analyse the uptake and user characteristics for emergency contraception, short-acting oral contraception, condoms and chlamydia treatment. In total, 54,309 pharmacy visits were analysed. A total of 30,473 females presented for emergency contraception. Most were supplied with an emergency contraceptive pill (98.6%, 30,052 out of 30,473), which was levonorgestrel in 57.4% of cases (17,255 out of 30,052). Of those females who attended for short-acting oral contraception, 54.3% (1764 out of 3247) were provided with the progesterone-only pill. Of those who were given chlamydia treatment, the majority received doxycycline (76.8%, 454 out of 591). A total of 74% (14,888 out of 19,998) of those who requested condoms were not provided with specific instructions on their use. Pharmacies have the potential to make a substantial contribution to the delivery of an integrated sexual health service including rapid access to emergency contraception, convenient delivery of short-acting hormonal contraception and treatment of chlamydia. Appropriate education, support and audit is required to ensure the delivery of high-quality care.

Mixed methods research requires data integration from multiple sources. Existing techniques are restricted to integrating a maximum of two data sources, do not provide step-by-step guidance or can be cumbersome where many data need to be integrated. We have solved these limitations through the development of the extended Pillar Integration Process (ePIP), a method which contributes to the field of mixed methods by being the first data integration method providing explicit steps on how to integrate data from three data sources. The ePIP provides greater transparency, validity and consistency compared to existing methods. We provide two worked examples from health sciences and automotive human factors, highlighting its value as a mixed methods integration tool.

This scoping review aims to explore what research has been conducted on issues related to medication usage experienced by people with a learning disability and their carers, and strategies and interventions that have been proposed or evaluated to address these issues. This scoping review is part of a larger mixed methods evidence synthesis project on interventions to promote the optimal use and management of medication for people with a learning disability. The findings of this scoping review will be fed into and subsequently integrated with the findings of the wider project (which includes a meta-ethnography of medication use issues; a quantitative review of intervention effectiveness and cost- effectiveness; and a mixed methods review of feasibility, acceptability, uptake, and facilitators and barriers of intervention implementation) using the Pillar Integration Process (11) or Metrices (12–14) in order to develop recommendations on what interventions have been shown to be effective and cost-effective, and how interventions need to be designed to support people with a learning disability and their carers to optimise their use of medications.