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Leon-Larios F, Gutiérrez Ales J, Puente Martínez MJ, Correa Rancel M, Lahoz Pascual I, Silva Reus I, Quílez Conde JC. Results of the National Contraception Survey Conducted by Sociedad Española de Contracepción (2020). J Clin Med 2022; 11:jcm11133777. [PMID: 35807063 PMCID: PMC9267860 DOI: 10.3390/jcm11133777] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 11/21/2022] Open
Abstract
Background: The National Contraception Survey conducted by Sociedad Española de Contracepción intends to know the sexual and contraceptive habits of Spanish women of reproductive age. Methods: A descriptive and cross-sectional study with random sample selection was conducted with women aged from 14 to 49 years old in July and August 2020. Results: A total of 1801 women participated in the study, of which 78.7% used some contraception method during their sexual relationships. The most frequently used methods were condoms (31.3%) and combined oral contraceptives (18.5%) at their last sexual encounter. A total of 25.7% used both condoms and pills, especially younger women and those who had no steady partners (p < 0.001). Use of Long-acting Reversible Contraceptives continues to be low, although a slight increase in their use is observed, and they are recommended for 50% of the users who need contraception. Counselling on contraception was provided to 64.3% of the women, mainly by their gynaecologists. Regarding the decision to use a contraceptive method, the one suggested by health professionals was more influential, although this was not the case for women aged less than 20 years old (p < 0.001). A total of 38.4% of the women have used emergency oral contraception at least once and 66.8% of those who do not make continuous use of contraception methods do so out of personal choice. Conclusions: It is necessary to deepen work on counselling and awareness among the population towards the use of efficient contraceptive methods that prevent unplanned pregnancies.
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Affiliation(s)
| | | | | | - Marta Correa Rancel
- Hospital Universitario de Canarias, 38320 Tenerife, Spain;
- Departamento de Obstetricia-Ginecología, Pediatría, Preventiva, Medicina Legal y Forense, Microbiología, Parasitología, Universidad de la Laguna, 38200 Santa Cruz de Tenerife, Spain
| | | | - Isabel Silva Reus
- Centro de Salud Sexual y Reproductiva de Villena, 03400 Alicante, Spain;
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Leon-Larios F, Ruiz-Ferron C, Jalon-Neira RM, Praena-Fernández JM. Nursing Students' Knowledge, Awareness, and Experiences of Emergency Contraception Pills' Use. J Clin Med 2022; 11:jcm11020418. [PMID: 35054112 PMCID: PMC8780468 DOI: 10.3390/jcm11020418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/31/2021] [Accepted: 01/11/2022] [Indexed: 02/04/2023] Open
Abstract
The emergency contraception pill (ECP) is a non-prescribed medication in Spain. However, there is not enough evidence of its use among young people to define sex education contents. The aims of this research were to describe the experiences of the use of the ECP in university students and analyze their knowledge, attitude, and awareness regarding the ECP. The cross-sectional, analytic study was conducted with nursing degree students at the University of Seville. A total of 478 students answered the questionnaire. All of the students (100%) had heard about the ECP and had a positive attitude towards this contraceptive. A total of 25.7% had used the ECP, mainly because a condom had failed or because they did not use any contraceptive at all. Deficiencies in knowledge are related with the ECPs' mechanism of action, efficacy after repeated use, and the type of ECP available. Female students who used no method at all or withdrawal, and who were over 20 years old, used ECP to a greater extent (p < 0.005). Further education initiatives focused on the use of the ECP, its efficacy, and typology are needed, particularly among future health professionals who will later educate other young people.
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Affiliation(s)
- Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (F.L.-L.); (J.-M.P.-F.)
| | - Cecilia Ruiz-Ferron
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (F.L.-L.); (J.-M.P.-F.)
- University Hospital Virgen del Rocío, 41013 Seville, Spain
- Correspondence:
| | | | - Juan-Manuel Praena-Fernández
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (F.L.-L.); (J.-M.P.-F.)
- Unit Biostatistic, Department of Statistics, Faculty of Medicine, University of Granada, 18016 Granada, Spain
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Chan MC, Munro S, Schummers L, Albert A, Mackenzie F, Soon JA, Ragsdale P, Fitzsimmons B, Renner R. Dispensing and practice use patterns, facilitators and barriers for uptake of ulipristal acetate emergency contraception in British Columbia: a mixed-methods study. CMAJ Open 2021; 9:E1097-E1104. [PMID: 34848550 PMCID: PMC8648349 DOI: 10.9778/cmajo.20200193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Ulipristal acetate 30 mg became available as prescription-only emergency contraception in British Columbia, Canada, in September 2015, as an addition to over-the-counter levonorgestrel emergency contraception. In this study, we determined dispensing and practice use patterns for ulipristal acetate, as well as facilitators of and barriers to emergency contraception for physicians, pharmacists and patients in BC. METHODS In the quantitative component of this mixed-methods study, we examined ulipristal acetate use from September 2015 to December 2018 using a database that captures all outpatient prescription dispensations in BC (PharmaNet) and another capturing market sales numbers for all oral emergency contraception in BC (IQVIA). We analyzed the quantitative data descriptively. We conducted semistructured interviews from August to November 2019, exploring barriers and facilitators affecting the use of ulipristal acetate. We performed iterative qualitative data collection and thematic analysis guided by Michie's Theoretical Domains Framework. RESULTS Over the 3-year study period, 318 patients filled 368 prescriptions for ulipristal acetate. Use of this agent increased between 2015 and 2018. However, levonorgestrel use by sales (range 118 897-129 478 units/yr) was substantially higher than use of ulipristal acetate (range 128-389 units/yr). In the 39 interviews we conducted, from the perspectives of 12 patients, 12 community pharmacists, and 15 prescribers, we identified the following themes and respective theoretical domains as barriers to access: low awareness of ulipristal acetate (knowledge), beliefs and experiences related to shame and stigma (beliefs about consequences), and multiple health system barriers (reinforcement). INTERPRETATION Use of ulipristal acetate in BC was low compared with use of levonorgestrel emergency contraception; lack of knowledge, beliefs about consequences and health system barriers may be important impediments to expanding use of ulipristal acetate. These findings illuminate potential factors to explain low use of this agent and point to the need for additional strategies to support implementation.
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Affiliation(s)
- Michelle C Chan
- Department of Obstetrics and Gynaecology (Chan, Munro, Fitzsimmons, Renner), Centre for Health Evaluation and Outcome Sciences (Munro), Department of Family Practice (Schummers, Soon) and Faculty of Pharmaceutical Sciences (Soon, Ragsdale), University of British Columbia; Women's Health Research Institute (Albert, Mackenzie), British Columbia Women's Hospital, Vancouver, BC
| | - Sarah Munro
- Department of Obstetrics and Gynaecology (Chan, Munro, Fitzsimmons, Renner), Centre for Health Evaluation and Outcome Sciences (Munro), Department of Family Practice (Schummers, Soon) and Faculty of Pharmaceutical Sciences (Soon, Ragsdale), University of British Columbia; Women's Health Research Institute (Albert, Mackenzie), British Columbia Women's Hospital, Vancouver, BC
| | - Laura Schummers
- Department of Obstetrics and Gynaecology (Chan, Munro, Fitzsimmons, Renner), Centre for Health Evaluation and Outcome Sciences (Munro), Department of Family Practice (Schummers, Soon) and Faculty of Pharmaceutical Sciences (Soon, Ragsdale), University of British Columbia; Women's Health Research Institute (Albert, Mackenzie), British Columbia Women's Hospital, Vancouver, BC
| | - Arianne Albert
- Department of Obstetrics and Gynaecology (Chan, Munro, Fitzsimmons, Renner), Centre for Health Evaluation and Outcome Sciences (Munro), Department of Family Practice (Schummers, Soon) and Faculty of Pharmaceutical Sciences (Soon, Ragsdale), University of British Columbia; Women's Health Research Institute (Albert, Mackenzie), British Columbia Women's Hospital, Vancouver, BC
| | - Frannie Mackenzie
- Department of Obstetrics and Gynaecology (Chan, Munro, Fitzsimmons, Renner), Centre for Health Evaluation and Outcome Sciences (Munro), Department of Family Practice (Schummers, Soon) and Faculty of Pharmaceutical Sciences (Soon, Ragsdale), University of British Columbia; Women's Health Research Institute (Albert, Mackenzie), British Columbia Women's Hospital, Vancouver, BC
| | - Judith A Soon
- Department of Obstetrics and Gynaecology (Chan, Munro, Fitzsimmons, Renner), Centre for Health Evaluation and Outcome Sciences (Munro), Department of Family Practice (Schummers, Soon) and Faculty of Pharmaceutical Sciences (Soon, Ragsdale), University of British Columbia; Women's Health Research Institute (Albert, Mackenzie), British Columbia Women's Hospital, Vancouver, BC
| | - Parkash Ragsdale
- Department of Obstetrics and Gynaecology (Chan, Munro, Fitzsimmons, Renner), Centre for Health Evaluation and Outcome Sciences (Munro), Department of Family Practice (Schummers, Soon) and Faculty of Pharmaceutical Sciences (Soon, Ragsdale), University of British Columbia; Women's Health Research Institute (Albert, Mackenzie), British Columbia Women's Hospital, Vancouver, BC
| | - Brian Fitzsimmons
- Department of Obstetrics and Gynaecology (Chan, Munro, Fitzsimmons, Renner), Centre for Health Evaluation and Outcome Sciences (Munro), Department of Family Practice (Schummers, Soon) and Faculty of Pharmaceutical Sciences (Soon, Ragsdale), University of British Columbia; Women's Health Research Institute (Albert, Mackenzie), British Columbia Women's Hospital, Vancouver, BC
| | - Regina Renner
- Department of Obstetrics and Gynaecology (Chan, Munro, Fitzsimmons, Renner), Centre for Health Evaluation and Outcome Sciences (Munro), Department of Family Practice (Schummers, Soon) and Faculty of Pharmaceutical Sciences (Soon, Ragsdale), University of British Columbia; Women's Health Research Institute (Albert, Mackenzie), British Columbia Women's Hospital, Vancouver, BC
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Meier S, Ball E, Jamieson KL, Sunkel SL, DeMaria AL. Translating policy to practice: theory-based formative research to improve messaging and over-the-counter access to emergency contraception in Florence, Italy. EUR J CONTRACEP REPR 2020; 25:285-292. [PMID: 32496887 DOI: 10.1080/13625187.2020.1774538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Italy's 2015 emergency contraception (EC) policy made EC available without prescription for individuals aged 18 years and older; however, women living in Italy continue to face barriers to accessing EC. The purposes of this study were to understand EC knowledge, attitudes and behaviours among women living in Italy and explore the impact of the 2015 policy. METHODS Researchers conducted 30 interviews with women living in Florence, Italy, aged 18-50 years and using the Italian health care system. Researchers used an expanded grounded theory approach to understand women's EC experiences, with diffusion of innovations (DOI) serving as a conceptual lens. Researchers completed open and axial coding to identify emerging themes. RESULTS Participants had low awareness of the 2015 EC policy and suggested increased messaging in strategic locations to overcome this barrier. They held positive and negative attitudes towards EC: while some perceived the advantage of EC compared with unintended pregnancy, others expressed concerns about irresponsible behaviour and safety. Finally, conscientious objection impacted access, despite women's desire for autonomous EC decision making. CONCLUSION The findings offer practical recommendations to guide EC messaging in Italy to increase women's access to EC. Recommendations include using theory- and audience-based methods to overcome gaps in policy knowledge and real and perceived barriers to EC access. Incorporating DOI as a theoretical framework with women's voices presents a novel opportunity to enhance policy and EC dissemination.
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Affiliation(s)
- Stephanie Meier
- Division of Consumer Science, Purdue University, West Lafayette, IN, USA
| | - Emily Ball
- College of Pharmacy, Purdue University, West Lafayette, IN, USA
| | | | - Scotlyn L Sunkel
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, USA
| | - Andrea L DeMaria
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, USA
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Ryu K, Lee M, Kim Y, Ban S, Choi M. [How Does Advance Provision of Emergency Contraceptives Affect Contraceptive Use and Sexual Activity Among Adolescents? Systematic Review and Meta-Analysis]. J Korean Acad Nurs 2018; 48:255-265. [PMID: 29968682 DOI: 10.4040/jkan.2018.48.3.255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to analyze the effect of emergency contraceptive pill on adolescent sexuality and contraceptive behaviors through a meta - analysis of intervention studies on advance provision of emergency contraceptives. This study aimed to provide objective data on the transition of general medicines to be discussed in relation to the reclassification of emergency contraceptive pills. METHODS Using electronic database, 1,820 studies written in Korean or English without limitation of the year were reviewed and for analysis, 5 studies were selected, in which emergency contraceptives were provided to adolescents. RESULTS The advance provision of emergency contraceptives has increased their use and shortened the time it takes to take contraceptive pills after unprotected sex. There was no change in the frequency of engaging in sexual intercourse and unprotected sex or in existing contraceptive behavior, pregnancy rates decreased, but there was no increase in sexually transmitted infection. CONCLUSION The results of this study provide objective grounds for the reclassification of emergency contraceptive pills and propose effective interventional programs on contraceptive education, such as on efficacy and side effects of the contraceptive drug and its proper use among the youth who engage in sexual activity, to improve their reproductive health.
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Affiliation(s)
- Kyungsoon Ryu
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Misoon Lee
- College of Nursing, Pusan National University, Yangsan, Korea.
| | - Younghae Kim
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Seonhwa Ban
- College of Nursing, Pusan National University, Yangsan, Korea
| | - Mihyang Choi
- Department of Nursing, Changshin University, Changwon, Korea
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Turillazzi E, Di Paolo M. Emergency contraception in adolescents. A grey area in Italian legislation. EUR J CONTRACEP REPR 2018; 23:237-241. [PMID: 29848112 DOI: 10.1080/13625187.2018.1471130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To explore Italian legislation and the social climate regarding the issue of emergency contraception (EC) in adolescents. RESULTS In recent years, in Italy, we have seen changes in the law and in attitudes towards EC. Since 2016, EC has been approved for sale as a non-prescription drug to women over the age of 18. However, the requirement for a prescription is still in force for women under 18. This raises questions such as the minor's ability to consent to family planning services to prevent pregnancy, and whether physicians require parental consent before providing an EC prescription to minors. This article explores these issues within the social and legislative context of adolescent reproductive health care, demonstrating a need for EC among Italian adolescents. CONCLUSION Making EC difficult for minors to access seems to respond to a political stance that clashes with existing social needs and with medical evidence that shows that EC is safe and reliable for use in adolescents, and that the increased use of EC has no negative effects on regular, ongoing contraceptive use or encourages risky sexual behaviour. Future interventions by Italian policy-makers should target these themes in order to make EC easily available to adolescents throughout the country.
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Affiliation(s)
- Emanuela Turillazzi
- a Section of Legal Medicine, Department of Surgical, Medical, Molecular and Critical Pathology , University of Pisa , Pisa , Italy
| | - Marco Di Paolo
- a Section of Legal Medicine, Department of Surgical, Medical, Molecular and Critical Pathology , University of Pisa , Pisa , Italy
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