Pharmacy Daily | Pharmacy has key contraception role

EMBEDDING the provision of bridging contraception through community pharmacies can help boost the uptake of effective contraception, a study reveals.

Data from the Bridge-it Study, conducted by researchers of the UK and Australia, found the provision of a three-month supply of the progestogen-only pill (75 g desogestrel/day) after dispensing the emergency contraceptive pill (levonorgestrel 1.5 or 3 mg) at no cost to patients, and giving information about local sexual and reproductive health (SRH) services, "had positive impacts on contraceptive practices in the short-term, and potentially in the longer term through overcoming some of the existing barriers to access and through increasing users' confidence in accessing contraception".

"The accessibility and convenience of the pharmacy setting was pivotal in making effective contraception more accessible," the authors said.

"Implementation appeared to be acceptable, welcomed and feasible to be routinely embedded within pharmacy practice.

"If widely implemented, provision of bridging contraception within community pharmacies has the potential to increase access to contraception and prevent more unintended pregnancies for women."

The researchers reported that many of the women involved in the trial reported that "being approached within the pharmacy and being offer a bridging method acted as a necessary prompt to change contraceptive practices".

"Many participants emphasised the pharmacy setting in particular as being pivotal to overcoming barriers faced in accessing contraception, some of them personal, including lack of time and embarrassment and some structural, such as difficulties accessing healthcare appointments within traditional settings," the authors said.

"Similarly, pharmacists and SRH clinical staff highlighted the accessibility and convenience of pharmacies as pivotal in overcoming such barriers, particularly for young people and students.

"While ease of access seemed to be a key mechanism of impact, analysis of screening log data and pharmacist interview data did highlight the ingrained nature of such barriers, with lack of time and potential embarrassment noted as key barriers to participation in the study."

The authors noted that a number of participants said that not being able to continue to access the progestogen-only pill through community pharmacy beyond the initial three-month supply was a significant barrier to longer term use of the contraceptive.

While supportive of the intervention a number of pharmacists noted that existing challenges related to store staffing, competing priorities and high workloads were challenges to embedding the program on a permanent basis.

The study was published online in BMJ Open.