scholarly journals The not so over-the-counter status of emergency contraception in Ontario: A mixed methods study with pharmacists

FACETS ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 429-439 ◽  
Author(s):  
Andréanne Chaumont ◽  
Angel M. Foster
Keyword(s):  
Mixed Methods ◽  
Continuing Education ◽  
Emergency Contraception ◽  
Service Providers ◽  
Descriptive Statistics ◽  
Mixed Methods Study ◽  
Over The Counter ◽  
Health Service Providers ◽  
Regulatory Status ◽  
Depth Interviews

Introduction: In Canada, the progestin-only dedicated pill is the most widely used method of emergency contraception (EC). This method gained over-the-counter status in Ontario in 2008. Our mixed methods study explored the progestin-only EC knowledge, attitudes, and provision practices of Ontario pharmacists. Methods: From June 2015 to October 2015, we collected 198 mailed surveys from Ontarian pharmacy representatives and conducted 17 in-depth interviews with a subset of respondents. We analyzed these data using descriptive statistics and for content and themes. Results: Results from our English/French bilingual survey indicate that respondents’ knowledge is generally accurate, but confusion persists about the mechanism of action and the number of times the drug can be used in one menstrual cycle. Nearly half (49%) of our survey respondents indicated that progestin-only EC pills are only available behind the counter. Interviewees strongly supported the introduction and promotion of more effective methods of EC in Ontario. Conclusion: Continuing education focusing on both the regulatory status of progestin-only EC and information about the medication appears warranted. Health Canada’s recent approval of ulipristal acetate for use as a post-coital contraceptive may provide a window of opportunity for engaging with health service providers, including pharmacists, about all available modalities of EC in Canada.

scholarly journals Introducing a “same day referral” program for post-coital IUD insertion in Ontario: A mixed-methods study with pharmacists

2017 ◽  
Vol 7 (2) ◽  
pp. 27-33 ◽  
Author(s):  
Andreanne Chaumont ◽  
Angel M. Foster
Keyword(s):  
Nous Avons ◽  
Emergency Contraception ◽  
Intrauterine Device ◽  
Full Range ◽  
Pilot Project ◽  
Pregnancy Prevention ◽  
Descriptive Statistics ◽  
Mixed Methods Study ◽  
Depth Interviews ◽  
Timely Referral

Objectives:Post-coital insertion of the Copper-T intrauterine device (IUD) is the most effective method of emergency contraception (EC). However, few women use this method of pregnancy prevention in Canada. Our study aimed to explore Ontario pharmacists’ knowledge of the IUD as EC and interest in a hypothetical “same day referral” program that would provide women seeking progestin-only EC with information about and a timely referral for post-coital IUD insertion.Methods: We received 198 mailed surveys from representatives of Ontario pharmacies and conducted 17 in-depth interviews with a subset of respondents in 2015. We analyzed the survey data using descriptive statistics and interviews for content and themes using both deductive and inductive techniques.Results:Our results suggest that Ontario pharmacists underestimate the efficacy of the IUD as EC and lack awareness of the protocols for use. Survey respondents and interviewees expressed support for a “same day referral” program in Ontario and believe more effective methods of EC should be easily accessible. Interviewees discussed current barriers to the use of IUDs as EC, including the up-front costs associated with insertion and a general lack of awareness about EC among health professionals and communities.Discussion: There is a significant need for continuing education on the full range of EC methods among pharmacists. Considerable enthusiasm exists for undertaking efforts to expand access to more effective EC methods. Developing a pilot project to facilitate timely referrals for post-coital IUD insertion appears warranted.RésuméObjectifs : L’insertion postcoïtale d’un dispositif intra-utérin (DIU) au cuivre est la méthode la plus efficace de contraception d’urgence (CU). Toutefois, peu de femmes au Canada utilisent cette méthode de prévention de la grossesse. Notre étude visait à explorer les connaissances des pharmacien(ne)s ontarien(ne)s sur le DIU utilisé comme CU, ainsi que leur intérêt pour un programme hypothéque d’orienta on du même jour, qui fournirait en temps opportun de l’information et une insertion postcoïtale d’un DUI aux femmes désirant une CU à progestatif seul. Méthodes : Nous avons reçu 198 sondages par la poste de la part de représentants de pharmacies ontariennes, et avons mené 17 entrevues détaillées avec un sous-ensemble des répondants en 2015. Nous avons analysé les données de l’enquête à l’aide de statisques descriptives, ainsi que le contenu et les thèmes des entrevues au moyen de méthodes déductives et inductives. Résultats : Nos résultats indiquent que les pharmacien(ne)s de l’Ontario sous-estiment la capcacité du DIU utilisé comme CU et ne connaissent pas les protocoles nécessaires. Les répondants à l’enquête et les sujets interrogés ont exprimé leur soutien au programme d’orientation du jour même en Ontario et croient que des méthodes plus efficaces de CU devraient être facilement accessibles. Les personnes interrogées ont discuté des obstacles actuels à l’utiisation du DIU utilisé comme CU, incluant les coûts initiaux associés à l’insertion, et le manque général de connaissances sur la CU parmi les professionnels de la santé et les communautés. Discussion : Il existe un besoin important de formations professionnelles continues pour les pharmacien(ne)s sur la gamme complète de CU. Plusieurs démontrent un enthousiasme considérable quant au déploiement d’efforts pour améliorer l’accès à des méthodes plus efficaces de CU. Il semble justifié d’instaurer un projet pilote qui faciliterait l’orientation pour la pose postcoïtale d’un DIU, et ce, en temps opportun.  

scholarly journals Regulatory standards and processes for over-the-counter availability of hormonal contraception and drugs for medical abortion in five countries in the Eastern Mediterranean Region

2021 ◽  
Vol 19 (S1) ◽  
Author(s):  
Anne Ammerdorffer ◽  
Mark Laws ◽  
Arinze Awiligwe ◽  
Florence Erb ◽  
Wallada Im-Amornphong ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health System ◽  
Emergency Contraception ◽  
Sexual And Reproductive Health ◽  
Self Care ◽  
Medical Abortion ◽  
Health System Strengthening ◽  
World Health ◽  
Over The Counter ◽  
Regulatory Status

AbstractThe World Health Organization 2019 WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights includes recommendations on self-administration of injectable contraception, over-the-counter (OTC) oral contraception and self-management of medical abortion. A review of the regulatory status of these two self-care interventions can highlight processes required to ensure that the quality of the medicines and safety of individuals are safeguarded in the introduction and scale-up in countries. This review outlines the legal regulatory status of prescription-only medicine (POM) and OTC contraceptives, including emergency contraception, and drugs for medical abortion in Egypt, Jordan, Lebanon, Morocco and Tunisia using information obtained from internet searches, regulatory information databases and personal contacts. In addition, the review examines whether the national medicines regulatory authorities have documented procedures available to allow for a change in status from a POM to OTC to allow for increased accessibility, availability and uptake of self-care interventions recommended by WHO. Egypt, Jordan and Lebanon have a documented national OTC list available. The only contraceptive product mentioned in the OTC lists across all five countries is ellaOne (ulipristal acetate for emergency contraception), which is publicly registered in Lebanon. None of the five countries has an official documented procedure to apply for the change of POM to OTC. Informal procedures exist, such as the ability to apply to the national medicines regulatory authority for OTC status if the product has OTC status in the original country of manufacture. However, many of these procedures are not officially documented, highlighting the need for establishing sound, affordable and effective regulation of medical products as an important part of health system strengthening. From a public health perspective, it would be advantageous for licensed products to be available OTC. This is particularly the case for settings where the health system is under-resourced or over-stretched due to health emergencies. Readiness of national regulatory guidelines and OTC procedures could lead to increased access, availability and usage of essential self-care interventions for sexual and reproductive health and rights.

Exploring young adults’ knowledge of and experiences with emergency contraception in Ontario, Canada: a mixed-methods study

Contraception ◽  
2018 ◽  
Vol 98 (4) ◽  
pp. 359
Author(s):  
S Hukku ◽  
A Gauthier-Beaupré ◽  
E Fortier ◽  
F Doci ◽  
G Veillet-Lemay ◽  
...  
Keyword(s):  
Young Adults ◽  
Mixed Methods ◽  
Emergency Contraception ◽  
Mixed Methods Study

scholarly journals Understanding health-related behavior among adolescents living with HIV in Lima, Peru

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carly A. Rodriguez ◽  
Emiliano Valle ◽  
Jerome Galea ◽  
Milagros Wong ◽  
Lenka Kolevic ◽  
...  
Keyword(s):  
Sexual Health ◽  
Service Providers ◽  
Care Providers ◽  
Hiv Diagnosis ◽  
Health Service Providers ◽  
Health Related ◽  
History Of ◽  
Data Source ◽  
Living With Hiv ◽  
Depth Interviews

Abstract Background The global HIV burden among adolescents ages 10–19 is growing. This population concurrently confronts the multifaceted challenges of adolescence and living with HIV. With the goal of informing future interventions tailored to this group, we assessed sexual activity, HIV diagnosis disclosure, combination antiretroviral therapy (cART) adherence, and drug use among adolescents living with HIV (ALHIV) in Lima, Peru. Methods Adolescents at risk or with a history of suboptimal cART adherence completed a self-administered, health behaviors survey and participated in support group sessions, which were audio recorded and used as a qualitative data source. Additionally, we conducted in-depth interviews with caregivers and care providers of ALHIV. Thematic content analysis was performed on the group transcripts and in-depth interviews and integrated with data from the survey to describe adolescents’ health related behaviors. Results We enrolled 34 ALHIV, of which 32 (14 male, 18 female, median age 14.5 years) completed the health behavior survey. Nine (28%) adolescents reported prior sexual intercourse, a minority of whom (44%) reported using a condom. cART adherence was highest in the 10–12 age group with 89% reporting ≤2 missed doses in the last month, compared to 36% in adolescents 13 years or older. Over 80% of adolescents had never disclosed their HIV status to a friend or romantic partner. Adolescents, caregivers, and health service providers described sexual health misinformation and difficulty having conversations about sexual health and HIV. Conclusions In this group of ALHIV, adherence to cART declined with age and condom use among sexually active adolescents was low. Multifactorial interventions addressing sexual health, gaps in HIV-related knowledge, and management of disclosure and romantic relationships are urgently needed for this population.

scholarly journals Accessing emergency contraception pills from pharmacies: the experience of young women in London

2020 ◽  
pp. bmjsrh-2019-200339
Author(s):  
Gillian Turnbull ◽  
Rachel H Scott ◽  
Sue Mann ◽  
Kaye Wellings
Keyword(s):  
Young Women ◽  
Emergency Contraception ◽  
Information Needs ◽  
Community Settings ◽  
Pharmacy Staff ◽  
Over The Counter ◽  
Women’S Perceptions ◽  
Depth Interviews ◽  
Prevention Of Recurrence

IntroductionOver-the-counter provision of emergency contraception pills (ECP) has increased since deregulation of progestogen-only formulations and is now the most common public health service provided by UK pharmacists. Important questions relate to women’s perceptions of their experience of receiving ECPs from pharmacists.MethodsQualitative study: in-depth interviews with young women reporting ECP use, recruited from clinic (10); pharmacy (6) and community settings (5) in London.ResultsKey advantages of pharmacy provision were ease and speed of access and convenience. Disadvantages included a less personal service, inadequate attention to information needs and to prevention of recurrence of ECP need, and unsupportive attitudes of pharmacy staff. Suggested service improvements included increasing privacy, providing more contraceptive advice, adopting a more empathetic approach and signposting follow-up services.ConclusionPharmacies are important in the choice of settings from which ECPs can be obtained and many aspects of pharmacy provision are appreciated by young women. There is scope to further enhance pharmacists’ role.

Assessing Sexual Assault Survivors' Access to Emergency Contraception: Results From a Mixed Methods Study in South Carolina

2010 ◽  
Vol 20 (4) ◽  
pp. 248-253 ◽  
Author(s):  
Teresa Harrison ◽  
Angel M. Foster ◽  
Sarah B. Martin ◽  
Cristina de la Torre ◽  
Lottie McClorin ◽  
...  
Keyword(s):  
South Carolina ◽  
Mixed Methods ◽  
Sexual Assault ◽  
Emergency Contraception ◽  
Mixed Methods Study ◽  
Sexual Assault Survivors ◽  
Assault Survivors
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