From request to dispensation: how adolescent and young adult females experience access to emergency contraception in pharmacies

Abstract

Purpose

Emergency contraception (EC) access was liberalised in 2002 in Switzerland by making it accessible in pharmacies without medical prescription. However, its dispensation still requires a confidential interview with a pharmacist. This qualitative study aims to explore experiences of adolescent and young adult (AYA) females who have gone to a pharmacy in order to obtain EC.

Materials and methods

Thirty interviews were conducted from April to August 2019 with females aged between 15 and 25 years old at the interview. Inclusion criteria was to have requested at least one EC in a pharmacy between 2014 and 2019. A thematic content analysis was performed to extract themes brought up by the participants.

Results

Some participants reported that the most difficult moment in the process was the request at the counter. The majority of participants were escorted in a private back room but opinions were divided regarding this isolation. Experiences were sometimes negative due to lack of information and knowledge regarding the dispensation process. The interview also has also a preventive aim, but the information given during it often focussed solely on the risk of vomiting. Several participants reported having perceived or received moral judgements from pharmacists.

Conclusions

Pharmacists are key resources and EC dispensation an opportunity for sexual health. This exploratory study presents several elements requiring the adaptation of practices in order to prevent them from becoming barriers for AYA to access EC. Concerns are regularly expressed by young women about privacy, embarrassment and judgement in the pharmacy context regarding contraception.

摘要

目的：2002年, 瑞士放宽了紧急避孕药（EC）的获取途径, 不需要医生处方就可以在药店买到紧急避孕药。然而, 它的发放仍然需要与药剂师进行保密的面谈。这项定性研究的目的是探索青少年和年轻成年（AYA）女性如何在药房中获得紧急避孕药。

材料和方法：2019年4月至8月进行了30次访谈, 接受访谈的女性年龄在15至25岁之间。纳入标准是在2014年至2019年期间至少在药店申请过一次EC。进行主题内容分析以提取参与者提出的主题。

结果：一些参与者报告说, 这一过程中最困难的时刻是在柜台提出请求。大多数参与者被护送到一个私密的密室中, 但对于这种隔离的做法, 大家意见不一。由于缺乏有关发放程序的信息和知识, 有些经历是负面的。访谈也有预防的目的, 但访谈中提供的信息往往只集中在呕吐的风险上。有几位参与者称她们感知到或收到了来自药剂师的道德评价。

结论：药剂师是关键的资源, EC的获取为性健康提供保障。这项探索性研究提出了几个需要调整的做法, 以防止它们成为AYA获得EC的障碍。年轻女性经常对隐私性、尴尬性和药房对避孕药的判断表示关注。

Keywords:

• Adolescents
• AYA
• emergency contraception
• interview
• morning-after pill
• pharmacy
• qualitative study young adults

Acknowledgements

Thanks to Diane Auderset for the interview transcripts.

Author contributions

All authors contributed to the conception and design of the study, to the data collection, analysis and interpretation, and to the draft and revision of the article. All authors gave final approval of the submitted version.

Notes

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Number within brackets are [Min – Max]

2 Age at first EC demand in pharmacy

Additional information

Funding

This work was supported by the Direction Générale de la Santé of the Canton of Vaud.