Evaluating Community Pharmacy Responses About Levonorgestrel Emergency Contraception by Mystery Caller Characteristics

Wilkinson, Tracey A.; Rafie, Sally; Clark, Porsche; Carroll, Aaron E.; Miller, Elizabeth

doi:10.1016/j.jadohealth.2017.11.303

Cited by 18 publications

(17 citation statements)

References 21 publications

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“…Wilkinson's findings are similar to previous work by their group and others [2À10]. Findings from these mystery caller studies showed commonly that access was encouragingly high [1,3,5,7] but that pharmacy advice was not always accurate regarding product use or adverse effects [1,3,5,8,9]. Most importantly, many studies conducted after the 2014 legislative changes found misinformation was given about age restrictions [1,3,5,8À10].…”

supporting

confidence: 76%

“…Since 2014, U.S. federal legislative changes allow young people of all ages to access levonorgestrel emergency contraception (EC) without prescription in licensed retail pharmacies. In this issue of the Journal, Wilkinson et al report a mystery caller study across five U.S. states exploring community pharmacy-mediated access to EC [1]. Wilkinson's findings are similar to previous work by their group and others [2À10].…”

supporting

confidence: 54%

“…One study found that young men had a 20% probability of not being able to access EC [7]. In the Wilkinson et al study reported this month, however, male adolescent callers more often received accurate information than female callers, which is intriguing [1]. The possible role of men in using EC as part of a strategy to prevent pregnancy in young women exposed to coercive sexual encounters makes this a difficult situation.…”

mentioning

confidence: 99%

See 2 more Smart Citations

A Call for Action: Supporting and Engaging Pharmacists in the Provision of Emergency Contraception

Gray¹

2018

Journal of Adolescent Health

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supporting

confidence: 76%

supporting

confidence: 54%

mentioning

confidence: 99%

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A Call for Action: Supporting and Engaging Pharmacists in the Provision of Emergency Contraception

Gray¹

2018

Journal of Adolescent Health

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“…Availability of LNG EC in pharmacies across the U.S. has been demonstrated in many studies over the years. Due to the many change to LNG EC access over the years, the most relevant studies are those in the last few years that found 80–83% same-day availability of LNG EC, compared to 90% in this study [13,14,15].…”

Section: Discussionmentioning

confidence: 56%

Emergency Contraception Counseling in California Community Pharmacies: A Mystery Caller Study

Ditmars

Rafie

Kashou³

et al. 2019

Pharmacy

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This study was conducted to determine which emergency contraception (EC) methods are offered by community pharmacists in response to patient calls. Female mystery callers called all community pharmacies in two California cities using standardized scripts. The callers inquired about options available to prevent pregnancy after sex and whether that method was available at the pharmacy, using follow-up probes if necessary. A total of 239 calls were completed in San Diego (n = 127, 53%) and San Francisco (n = 112, 47%). Pharmacists indicated availability at most sites (n = 220, 92%) with option(s) reported as levonorgestrel only (LNG; n = 211, 88.3%), both ulipristal acetate (UPA) and LNG (n = 4, 1.6%), UPA only (n = 1, 0.4%), or non-specific EC (n = 4, 1.7%). Nineteen pharmacies (7.9%) did not have EC available on the day of the call. Following additional probing, some pharmacists discussed UPA (n = 49, 20.5%) or the copper intrauterine device (n = 1, 0.4%) as EC options. LNG EC products were available same-day in 90.1% of pharmacies, whereas UPA was available same-day in 9.6% of pharmacies. The majority of pharmacies called in this study offered and stocked at least one EC option, but the focus of discussions was on LNG and matched what was in stock and available.

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“…The SmPCs do not specify age limits, but the BAK guidelines recommend not to dispense EC to girls under 14 without a prescription or the consent of a parent or legal guardian [9,32]. However, it remains arguable if the overall restrictive EC dispensing due to pharmacists' concerns about the safe use of EC may constitutes an (unnecessary) barrier for women who require early and effective pregnancy prevention [33]. As indicated, EC have an adequate safety profile, and the benefit outweigh the risk [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Trends in dispensing oral emergency contraceptives and safety issues: a survey of German community pharmacists

et al. 2019

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Background Oral emergency contraceptives containing levonorgestrel or ulipristal acetate are available without prescription and only in pharmacies in Germany since March 2015. Due to this change community pharmacists are responsible for evaluating whether the product is appropriate and to educate women on proper use. Objective To measure the utilization of emergency contraceptives without a prescription and describe potential concerns and safety issues identified by community pharmacists in Germany. Setting The Drug Commission of German Pharmacists' nationwide network of reference pharmacies which includes 860 community pharmacies. Methods Reference community pharmacies were asked to participate in the eleven-questions online survey. Respondents were asked to recall their experiences with oral emergency contraceptives in the past 3 months. Data were collected between January 8 and February 19, 2018. Main outcome measure The survey focused on the utilization of emergency contraceptives without a prescription in Germany, and on the pharmacists' experiences with (potential) problems and concerns regarding safe use. Results In total, 555 community pharmacies (64.5%) participated. Overall 38.2% of community pharmacists stated they dispensed six to ten courses of emergency contraceptives within the past 3 months. In addition, 54.3% of the pharmacists estimated they dispensed emergency contraceptives exclusively without prescription and 35.9% dispensed more than 30% of emergency contraceptives during night-time and emergency services. Moreover, 82.8% of pharmacists stated that emergency contraceptives were requested not by the women concerned but a third person and 44.3% identified uncertainties in woman's self-diagnosis. Three out of four pharmacists had concerns about the effective and safe use of emergency contraceptives. In situations suggesting sexually transmitted diseases, or suspicion for use of force, 59.5% and 55.8% of the pharmacists, respectively, dispensed emergency contraceptives. In cases of acute health impairment or chronic disease, or (potentially) relevant drug/drug interaction, the vast majority (91.0% and 90.5%) did not. Here, most pharmacists referred to gynecologists. Conclusion Pharmacists had safety concerns when dispensing emergency contraceptives. Professional expertise in evaluating the need for oral emergency contraceptives and the proper use is needed.

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Evaluating Community Pharmacy Responses About Levonorgestrel Emergency Contraception by Mystery Caller Characteristics

Abstract: Persistent barriers to accessing EC exist for adolescents despite regulatory changes to make EC available over-the-counter, especially for females. Additional work to remove these barriers is needed to assure timely access for those who require effective pregnancy prevention.

Cited by 18 publications

References 21 publications

A Call for Action: Supporting and Engaging Pharmacists in the Provision of Emergency Contraception

A Call for Action: Supporting and Engaging Pharmacists in the Provision of Emergency Contraception

Emergency Contraception Counseling in California Community Pharmacies: A Mystery Caller Study

Trends in dispensing oral emergency contraceptives and safety issues: a survey of German community pharmacists

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