Emergency hormonal contraceptive service provision via community pharmacies in the UK: a systematic review of pharmacists' and young women's views, perspectives and experiences

AIMS

Unintended pregnancy among young people remains a major public health problem in the UK, despite recent evidence suggesting that the number of teenage pregnancies in England is falling. Community pharmacies have the potential to reduce health inequalities among young women through improved and appropriate access to sexual health services. This study seeks to examine the views, perceptions and experiences of young women and community pharmacists concerning emergency hormonal contraceptive (EHC) provision from community pharmacies in the UK.

METHODS

Six electronic databases were searched for articles published in English between 2000 and 2017. Titles and abstracts were screened by two researchers according to the inclusion criteria.

RESULTS

A total of eight papers reporting studies carried out within the UK were included. Five key themes were identified from the perspectives of young women: convenience and ease of access, embarrassment and non-judgemental services, free services, confidentiality and pharmacist being helpful. Six key themes were identified from the perspectives of the pharmacists: concerns about supply of EHC, improved access, no need for appointment, confidentiality, free EHC and training.

CONCLUSIONS

The review suggests that services should be designed based on the views, perceptions and experiences of the service users and providers in order to reduce inequities to access of EHC. Pharmacists who provide EHC should continuously upgrade their knowledge base through training if the sexual health needs of the young women who access pharmacies are to be adequately met.

A comparison of community pharmacists' views of over-the-counter omeprazole and simvastatin

PURPOSE

Simvastatin and omeprazole were re-classified to pharmacy status in Great Britain in summer 2004. The purpose of this study was to compare the views of community pharmacists on over-the-counter (OTC) omeprazole and simvastatin.

METHODS

A pre-piloted questionnaire mailed to 2000 randomly selected community pharmacy premises, with open questions relating to pharmacists' views. Pharmacists' attitudes on aspects of supply were sought using Likert scales. Content analysis was performed on responses to the open question and Wilcoxon signed ranks test (z) used to compare responses to the attitudinal statements.

RESULTS

One thousand one hundred and fifty-six questionnaires were returned (57.8%). Themes around omeprazole illustrated positive views compared to concerns relating to simvastatin. Whereas omeprazole was seen as a welcome addition, there were issues around the poor evidence base for simvastatin. Further simvastatin related concerns were in areas of cardiovascular risk assessment, adverse drug reactions and likelihood of patients not committing to therapy. For both agents, excessive cost was an issue. Nearly three-quarters of pharmacists agreed they were entirely confident about selling omeprazole (835, 73%), significantly more than simvastatin (691, 60%); (z = 9.243, p < 0.001).

CONCLUSIONS

Two re-classified medicines have raised common and product-specific themes. Many themes relate to clinical governance such as evidence-based practice, risk management and continuing professional development (CPD). Views on the availability and circumstances surrounding the OTC supply differ in certain regards, for example, more believe that they should be involved in the sale of simvastatin personally than for sales of omeprazole.

Awareness and perceptions of emergency contraception among retail pharmacists in Kuwait

OBJECTIVE

To describe the awareness and perceptions of hormonal emergency contraception (EC) among retail pharmacists.

SETTING

Private retail pharmacies in Kuwait City.

METHOD

A self-administered questionnaire was developed to elicit pertinent demographic information as well as awareness of and concerns about EC and administered to the senior pharmacist in 51 randomly selected private retail pharmacies.

MAIN OUTCOME MEASURE

Proportion of pharmacists aware of EC and who had recommended EC.

RESULTS

The respondents had a mean (SD) age of 34.2 (7.7) years; 58.8% were male, and all but one were non-Kuwaiti. The median practice experience of the pharmacists was 6 years. Oral contraceptives and male condoms were universally available in the pharmacies, but none stocked emergency contraceptives, female condoms, or diaphragms. Twenty respondents (39.2%; 95% confidence intervals 25.5-53.9%) said they were aware of EC, and 4 (7.8%) that they had ever offered EC. Nine (17.6%) respondents saw EC as offering no advantages over other contraceptive measures and effectiveness was perceived to be low. Most cited concerns were of encouraging irresponsible behaviour and women relying on EC in place of regular contraceptive measures. Religious opposition (41.2%), lack of awareness by clients (51.0%) and lack of awareness by health providers (35.3%) were seen as the most significant obstacles to provision of EC.

CONCLUSION

Knowledge of EC is poor among community pharmacists in Kuwait. Action is needed to address this deficit and to make EC more accessible to women who wish to use it.