Over‐the‐Counter Pill Provision: Evidence from Jamaica

Abstract

Although many countries allow over-the-counter distribution of oral contraceptives, doubt remains about whether such provision is safe for the user. The greatest concern is whether women with contraindications for use are given access to the pill. Clearly, women without such contraindications should be given access to it and be offered adequate information about its correct use. In 15 pharmacies in Jamaica, mystery clients approached pharmacists to determine their willingness to sell oral contraceptives and to solicit information from them about correct use of the method. In addition to data from mystery-client observations, interviews were conducted with 78 pharmacists and with 524 pharmacy customers who bought oral contraceptives, providing complementary information about knowledge of, attitudes toward, and experiences with the method. Analysis of the combined findings suggests that over-the-counter provision of oral contraceptives is a safe, practical, and effective method of distribution in Jamaica.

A review of the provision of appropriate advice by pharmacy staff for self-medication in developing countries

“…Regarding sampling representativeness; 8 studies used non-random sampling, including: convenience sampling (5 studies), 26,27,29,34,36 purposive sampling (2 studies), 23,37 and quota sampling (1 study). 44 One study, however, did not report the type of sampling used.…”

“…Eleven studies were conducted in Asian regions: India, 44 Indonesia, 37 Pakistan, 26,27 Thailand, 19,39,40 Turkey, 18 and Vietnam. 22,24,32 Six studies came from African regions: Gambia, 33 Kenya, 29 South Africa, 41,45 Sudan, 36 and Zimbabwe, 35 Lastly, 11 studies were undertaken in Latin American and Caribbean regions: Bolivia, 25 Brazil, 34,38 Colombia, 43 Mexico, 20,21,31,42 Jamaica, 23 Latin American, 30 and both Guatemala and Mexico. 28 A wide variety of scenarios (n ¼ 64) were covered.…”

“…However, in 53 of these 64 scenarios (83%), appropriate advice was provided to a minority of patients (range 0%-47%). [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][35][36][37][38][39][40][42][43][44][45] The definition of appropriate advice varied across studies (Table 1). In 19 of the 28 included studies, authors used their own definition to decide whether the advice provided was considered appropriate.…”

“…In 19 of the 28 included studies, authors used their own definition to decide whether the advice provided was considered appropriate. [18][19][20][21]23,[25][26][27][28]30,31,[35][36][37][39][40][41][42][43] In 8 studies, authors used a national or international Table 1 The criteria to appraise the included studies (1) Did the study address a focused issue? (2) Was the research method appropriate to answer the aim?…”

“…43 Several methods were used to conduct these 28 studies. The patient simulation method was employed in 20 studies, 19,[21][22][23][24][25][26][27][28][29]31,[34][35][36][37][38][39]41,43,44 pharmacy staff interview was performed in 4 studies, 20,30,42,45 and a combination of patient simulation with pharmacy staff interview was employed in 4 studies. 18,32,33,40 The provision of appropriate advice…”