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

2020 ◽  
pp. bmjsrh-2020-200648 ◽  
Author(s):  
Anna Glasier ◽  
Paula Baraitser ◽  
Lisa McDaid ◽  
John Norrie ◽  
Andrew Radley ◽  
...  

BackgroundEmergency contraception (EC) was approved in the UK as a pharmacy medicine for purchase without prescription in 2001. 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.

2022 ◽  
Vol 22 (2) ◽  
pp. 35-45
Author(s):  
Mary Lou O'Neil ◽  
Bahar Aldanmaz

Emergency contraception (EC) has been and remains available in Turkey without prescription since 2002. This study attempted to determine the availability of emergency contraception from pharmacies in Istanbul, Turkey and whether the identity of the purchaser had any impact on availability. More specifically, we sought to understand if young women feel shamed or denied access to EC. This study employed a mystery patient/shopper approach where mystery patients attempted to purchase emergency contraception from a random sample of 352 pharmacies in Istanbul. Mystery shoppers, ages 18-22, were trained and provided a standard scenario and identity. The identities included: conservative/ religious female; secular/modern female; and male. After each pharmacy visit, the mystery patients recorded the details of their attempts to purchase EC. In 95.4% of visits mystery shoppers were able to purchase EC. Despite the availability of several types of EC, little choice was given to shoppers. Male mystery shoppers were given more choice of EC than their female counterparts and were more often able to purchase the less expensive form of EC. In the majority of transactions, pharmacists offered no medical instructions or recommendations. EC is widely available from pharmacies in Istanbul but lack of choice and information from pharmacists result in a less than ideal health care experience.


2021 ◽  
Vol 103 ◽  
pp. 106321
Author(s):  
Susmita Kashikar-Zuck ◽  
Matthew S. Briggs ◽  
Sharon Bout-Tabaku ◽  
Mark Connelly ◽  
Morgan Daffin ◽  
...  

2021 ◽  
pp. 026921632110087
Author(s):  
Liz Jamieson ◽  
Emily Harrop ◽  
Margaret Johnson ◽  
Christina Liossi ◽  
Christine Mott ◽  
...  

Background: Oral morphine is frequently used for breakthrough pain but the oral route is not always available and absorption is slow. Transmucosal diamorphine is administered by buccal, sublingual or intranasal routes, and rapidly absorbed. Aim: To explore the perspectives of healthcare professionals in the UK caring for children with life-limiting conditions concerning the assessment and management of breakthrough pain; prescribing and administration of transmucosal diamorphine compared with oral morphine; and the feasibility of a comparative clinical trial. Design/ participants: Three focus groups, analysed using a Framework approach. Doctors, nurses and pharmacists ( n = 28), caring for children with life-limiting illnesses receiving palliative care, participated. Results: Oral morphine is frequently used for breakthrough pain across all settings; with transmucosal diamorphine largely limited to use in hospices or given by community nurses, predominantly buccally. Perceived advantages of oral morphine included confidence in its use with no requirement for specific training; disadvantages included tolerability issues, slow onset, unpredictable response and unsuitability for patients with gastrointestinal failure. Perceived advantages of transmucosal diamorphine were quick onset and easy administration; barriers included lack of licensed preparations and prescribing guidance with fears over accountability of prescribers, and potential issues with availability, preparation and palatability. Factors potentially affecting recruitment to a trial were patient suitability and onerousness for families, trial design and logistics, staff time and clinician engagement. Conclusions: There were perceived advantages to transmucosal diamorphine, but there is a need for access to a safe preparation. A clinical trial would be feasible provided barriers were overcome.


2011 ◽  
Vol 38 (10) ◽  
pp. 2095-2104 ◽  
Author(s):  
JACOB KARSH ◽  
EDWARD C. KEYSTONE ◽  
BOULOS HARAOUI ◽  
J. CARTER THORNE ◽  
JANET E. POPE ◽  
...  

Objective.Current clinical trial designs for pharmacologic interventions in rheumatoid arthritis (RA) do not reflect the innovations in RA diagnosis, treatment, and care in countries where new drugs are most often used. The objective of this project was to recommend revised entry criteria and other study design features for RA clinical trials.Methods.Recommendations were developed using a modified nominal group consensus method. Canadian Rheumatology Research Consortium (CRRC) members were polled to rank the greatest challenges to clinical trial recruitment in their practices. Initial recommendations were developed by an expert panel of rheumatology trialists and other experts. A scoping study methodology was then used to examine the evidence available to support or refute each initial recommendation. The potential influence of CRRC recommendations on primary outcomes in future trials was examined. Recommendations were finalized using a consensus process.Results.Recommendations for clinical trial inclusion criteria addressed measures of disease activity [Disease Activity Score 28 using erythrocyte sedimentation rate (DAS28-ESR) > 3.2 PLUS ≥ 3 tender joints using 28-joint count (TJC28) PLUS ≥ 3 swollen joint (SJC28) OR C-reactive protein (CRP) or ESR > upper limit of normal PLUS ≥ 3 TJC28 PLUS ≥ 3 SJC28], functional classification, disease classification and duration, and concomitant RA treatments. Additional recommendations regarding study design addressed rescue strategies and longterm extension.Conclusion.There is an urgent need to modify clinical trial inclusion criteria and other study design features to better reflect the current characteristics of people living with RA in the countries where the new drugs will be used.


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