Characterization of the Use of Emergency Contraception from Sentinel Pharmacies in a Region of Southern Europe

Jambrina, Anna M.; Rius, Pilar; Gascón, Pilar; Armelles, Mercé; Camps-Bossacoma, Mariona; Franch, Àngels; Rabanal, Manel

doi:10.3390/jcm10132793

Cited by 6 publications

(17 citation statements)

References 14 publications

(21 reference statements)

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“…In this respect, the sentinel pharmacies of Catalonia have participated in projects such as obtaining daily information on acute respiratory diseases. The aim was detecting the start of the annual flu epidemic in advance and monitoring the dispensing of contraception with a goal of obtaining information on the profiles of users and other conditions that may influence and provide criteria to evaluate and/or improve the Public Health Emergency Contraception Program’s strategies [ 12 , 13 ].…”

Section: Resultsmentioning

confidence: 99%

“…Detailed results of some of these activities have been published in international scientific journals [ 11 , 12 , 13 ]. Others are still under study.…”

Section: Resultsmentioning

confidence: 99%

“… Use of tramadol for non-oncologic pain: the majority (60%) of patients have needed to increase the dose of tramadol without consulting a doctor, and 13.8% have used it for symptoms other than pain. Characterization of the use of emergency contraception: many users (44.2%) said they had taken the medication on other occasions, and the number of women who requested the medication when they were recurring was higher than the first users (85.8% vs. 75.4%) [ 13 ]. Influenza syndromic surveillance: sentinel pharmacies make it possible to detect the start of the flu epidemic a week earlier than health centers [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…Characterization of the use of emergency contraception: many users (44.2%) said they had taken the medication on other occasions, and the number of women who requested the medication when they were recurring was higher than the first users (85.8% vs. 75.4%) [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

“…During the 2017–2021 period, the network of sentinel pharmacies in Catalonia facilitated the effectiveness and efficiency of traditional surveillance programs by obtaining valid data related to the safety of medicines generated by the dynamics of health care in the community pharmacy office. Furthermore, it made it possible to identify individual and population-level behaviors and to provide an overall view of the burden of the disease and the risks associated with the use of medication [ 11 , 12 , 13 ]. Likewise, this five-year study process allowed the optimization of the selection method of community pharmacies based on the experience gained in the studies that had been carried out.…”

Section: Introductionmentioning

confidence: 99%

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Creation and Implementation of a New Sentinel Surveillance Model in Pharmacy Offices in Southern Europe

Jambrina

Rams

Rius³

et al. 2022

IJERPH

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Traditionally, health sentinel networks have focused on the reporting of data by primary care physicians and hospitals, ignoring the role of the community pharmacist as an expert in drugs. The objective of this study was to describe a method for creating a network of sentinel pharmacies in a region of Southern Europe in order to have a pharmaceutical surveillance system that is representative of the territory to be monitored and that can respond to any events or incidents that can be followed up by the community pharmacy. The creation process was carried out in three phases: a first phase of selection through a cluster and population analysis and a final adjustment, a second phase of voluntariness and random selection, and a third phase of training and implementation of the network. A sentinel network of 75 community pharmacies has been established in Catalonia. The network monitors 2.47% of the total population with a homogeneous proportion of urban (42), rural (30), and mountain-area (3) pharmacies based on the particular characteristics of the territory. This model allows increased surveillance in the territory, objectively and representatively detects problems arising from the use of medicines, and establishes improvement strategies of public health.

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Section: Resultsmentioning

confidence: 99%

“…Detailed results of some of these activities have been published in international scientific journals [ 11 , 12 , 13 ]. Others are still under study.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Creation and Implementation of a New Sentinel Surveillance Model in Pharmacy Offices in Southern Europe

Jambrina

Rams

Rius³

et al. 2022

IJERPH

Self Cite

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Acceptability of an on-demand pericoital oral contraceptive pill: a systematic scoping review

Bell,

Gibbs,

Winskell

et al. 2024

Reprod Health

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Background Access to an on-demand pericoital oral contraceptive pill – used to prevent pregnancy within a defined window around sexual intercourse – could offer women more reproductive agency. A contraceptive with this indication is not currently available in any market. This review aims to understand international user appeal for an on-demand pericoital oral contraceptive pill. Methods Systematic scoping review, comprising 30 peer-reviewed papers published between 2014–2023. Results Data from 30 papers reporting on research from 16 countries across five World Health Organisation regions suggests widespread user appeal for on-demand oral contraceptive pills that can be used peri- or post-coitally, especially among women who are younger, more educated or who have less frequent sex. Women of varying age, wealth, employment or relationship status, and with different prior experience of using modern contraceptives, were also interested. Women identified clear rationale for use and preference of these types of product: close alignment with women’s sexual lives that comprised unplanned, spontaneous or occasional sex; perceived convenience and effectiveness; discreet use of pills to negotiate contextual circumstances that constrained their reproductive agency. Factors inhibiting use included knowledge barriers and attitudes of service providers, a lack of knowledge and misinformation among end-users, women’s dislike of menstrual side effects and myths related to the effects of hormone content on future fertility. Conclusions Introduction of an on-demand pericoital oral contraceptive pill could expand contraceptive choice for diverse women experiencing unmet need for modern contraception and constrained sexual and reproductive agency. Priorities for future research include: broadening the geographical scope of evidence to include SE Asia and the Pacific, and international rural and peri-urban settings; documenting the perspectives of adolescents and unmarried young people; identifying opportunities for innovation in the supply channels to enhance appropriate, affordable access to on-demand oral contraceptives; and unpacking how to bring new pericoital contraceptives to the market in a variety of international settings.

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Ulipristal Acetate (UPA) in Emergency Contraception: The Mechanism of Action, Toxicity and Perspectives

Mozzanega

2022

MRAJ

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After recalling that Levonorgestrel Emergency Contraceptive Pills never delay or suppress ovulation, but impair the luteal body functions, and, consequently, the embryo-implantation, we focus on the mechanism of action (MOA) of ellaOne®: micronized UPA (Ulipristal Acetate) 30mg and on UPA- toxicity. EMA and, after it, the National Drug Regulatory Institutions and the most renowned International Gynecological Societies present ellaOne® as an anti-ovulatory drug which is safe even in repeated assumption, also during the same menstrual cycle. We’ll try to understand whether this dogma is supported by experimental data in literature. As to the MOA, EMA reports (EMEA-261787-2009) that Ulipristal blocks the synthesis of the proteins necessary to begin and maintain pregnancy, and that Ulipristal and mifepristone were approximately equipotent as to their ability to terminate pregnancy. Besides, EMA further evidences (EMA/73099/2015) that it is unknown whether it is possible to use ellaOne® for abortion. Data in Literature evidence that ellaOne® can delay ovulation only when is taken in the very first fertile days of the cycle. In the pre-ovulatory, most fertile, days - when most intercourses do occur and over 70% fertilizations ensue - it never prevents ovulation, like placebo. On the contrary, whenever it is taken in the cycle, it consistently impairs the endometrium that becomes an inhospitable ground for the embryo: endometrial gene expression is completely subverted compared with that of the normal luteal phase. Recently, an UPA-based drug used for uterine fibroids-treatment (Esmya®) was withdrawn from the market because it caused fulminant hepatitis requiring transplantation (EMA/455818/2020). It was prescribed by the hospital for 3-6 months and carefully followed-up. The strict post-marketing surveillance allowed to link UPA-administration and tissue-accumulation to liver-failure. Surprisingly EMA, while revoking Esmya®, warranted for the safety of ellaOne®, though it is taken by millions of women unaware of the risk, repeatedly without prescription, without medical supervision and any possibility of post-marketing surveillance, in UPA-cumulating doses even greater than with Esmya®. Finally, we criticize the attempt to propose UPA in daily contraceptive pills, at doses even double than in Esmya® and for much longer periods, to fertile women aiming at preserving their fertility and health.

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Characterization of the Use of Emergency Contraception from Sentinel Pharmacies in a Region of Southern Europe

Cited by 6 publications

References 14 publications

Creation and Implementation of a New Sentinel Surveillance Model in Pharmacy Offices in Southern Europe

Creation and Implementation of a New Sentinel Surveillance Model in Pharmacy Offices in Southern Europe

Acceptability of an on-demand pericoital oral contraceptive pill: a systematic scoping review

Ulipristal Acetate (UPA) in Emergency Contraception: The Mechanism of Action, Toxicity and Perspectives

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