Pharmacist recommendations for emergency contraception in Belgium: a simulated user study

Abstract

Background

Emergency contraception reduces the risk of unintended pregnancy, after unprotected sexual intercourse or contraceptive failure. In Belgium, emergency contraception is available without a prescription and pharmacists play therefore a crucial role in dispensing emergency contraception.

Aim

This study assesses the dispensing practices of emergency contraception by pharmacists in two regions of Belgium.

Method and design

Simulated patient study, using a predefined scenario, evaluating a request for emergency contraception. The scenario involves a 25-year-old woman not using contraception, who had unprotected sexual intercourse 84 h (3.5 days) ago. Her last menstrual period was 10 days ago.

Population

260 pharmacies were randomly selected. Principal outcome: proportion of pharmacists who deliver the adequate emergency contraception. We considered the following responses as adequate: Prescribing ulipristal acetate or redirecting to another pharmacy, in case of unavailability, or referring for a copper IUD

Results

We analysed the data obtained in 216 pharmacies (216/260 = 83.1%). In 64% of cases, adequate dispensing of emergency contraception (dispensing of ulipristal acetate or referral for intrauterine device insertion) occurred. There was an association between correct dispensing and asking appropriate questions, such as the date of the last menstrual period and the date of the risky sexual intercourse.

Conclusion

More than one-third of visited pharmacies did not distribute appropriate emergency contraception, underlining the need for improvement. We hypothesise that this may be achieved with appropriate training, use a dispensing checklist.

SHORT CONDENSATION

We assesses the dispensing of emergency contraception by pharmacists using a simulated patient. More than one-third of visited pharmacies did not distribute appropriate emergency contraception, underlining the need for improvement.

Keywords:

• Emergency contraception
• community pharmacy
• simulated observational study

Acknowledgement

This study was used, by Gabrielle Vander Steen as a medical student thesis for obtaining the grade of MD and by Jeanne Ropers for obtaining the grade of general practitioner.

Authors contribution

GVS and JR contributed equally to the study. The study conception was developed by GVS, JR, SR and YM. GVS and JR were the simulated patients, collected and analysed the date and wrote the first draft. The other authors contributed to the final MS. The first draft was presented as a student paper by GVS for obtaining her degree of medical studies and by Jr for obtaining her general practice thesis.

Disclosure statement

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

Data availability statement

The data will be available on request.