Emergency contraception from the pharmacy 20 years on: a mystery shopper study

Abstract

BackgroundEmergency contraception (EC) was approved in the UK as a pharmacy medicine for purchase without prescription in 1991. Twenty years later we conducted a study to characterise routine practice pharmacy provision of EC.Study designMystery shopper study of 30 pharmacies in Edinburgh, Dundee and London participating in a clinical trial of contraception after EC.MethodsMystery shoppers, aged ≥16 years, followed a standard scenario requesting EC. After the pharmacy visit, they completed a proforma recording the duration of the consultation, where it took place, and whether advice was given to them about the importance of ongoing contraception after EC.ResultsFifty-five mystery shopper visits were conducted. The median reported duration of the consultation with the pharmacist was 6 (range 1–18) min. Consultations took place in a private room in 34 cases (62%) and at the shop counter in the remainder. In 27 cases (49%) women received advice about ongoing contraception. Eleven women (20%) left the pharmacy without EC due to lack of supplies or of a trained pharmacist. Most women were generally positive about the consultation.ConclusionsWhile availability of EC from UK pharmacies has undoubtedly improved access, the necessity to have a consultation, however helpful, with a pharmacist introduces delays and around one in five of our mystery shoppers left without getting EC. Consultations in private are not always possible and little advice is given about ongoing contraception. It is time to make EC available without a pharmacy consultation.

The Quality of Counselling for Oral Emergency Contraceptive Pills—A Simulated Patient Study in German Community Pharmacies

“…The fact that in slightly more than 20% of all test purchases, a medicinal product was not dispensed, or the wrong medicinal product was dispensed is problematic [ 77 ]. This situation is all the more significant for such an indication in which the consequence of providing the wrong advice or not dispensing the correct medicinal product—possibly an unwanted pregnancy—must be considered to be very high.…”

Use of effective contraception following provision of the progestogen-only pill for women presenting to community pharmacies for emergency contraception (Bridge-It): a pragmatic cluster-randomised crossover trial

“…Notably, three-quarters of women in the control group of the Bridge-it trial received advice about contraception compared with a half of women in the mystery shopper study designed to characterise standard care. 12 …”

“…Mystery shopper visits were done just before control group recruitment started to document the content of standard care consultations on emergency contraception and these data have been published. 12 …”

Provision of the progestogen-only pill by community pharmacies as bridging contraception for women receiving emergency contraception: the Bridge-it RCT

“…usual advice about ongoing contraception). Mystery shopper visits with simulated patients 12,13 were conducted in the pharmacies just before recruitment started in the control group to document the content of the standard care EC consultations (see Chapter 4).…”

“…In addition, in some UK studies, fewer than half of pharmacists gave advice about ongoing contraception after EC. 12,13 There is a lack of evidence on interventions to increase uptake of effective contraception after EC. We conducted a literature search of PubMed English-language articles from 2000 to March 2020 using search terms (((bridging) OR bridge)) AND (emergency contracept*) and identified only two relevant articles.…”