Pharmacy teams are embracing the opportunity to make a difference with a new emergency contraception medicine. Ross Ferguson reports.

It is not often that new product launches in pharmacy immediately gain the attention of pharmacists and their teams and provide a potential platform for the profession to showcase its strengths. However this has happened with ellaOne (ulipristal acetate 30mg) – and for a number of very good reasons. Forget the sensationalist, irresponsible, emotive tabloid headlines.

The launch of ellaOne, the new EHC product, is really about widening choice for women of all ages and preventing unwanted pregnancy. Indeed this approach has been endorsed by the National Institute for health and Care Excellence (NICE).^1,2 The reality is that access to emergency hormonal contraception from pharmacies is already having an impact on unwanted pregnancies – and the launch of this new product should further improve matters.

Compared to the existing EHC product on the market, ellaOne would appear to have some clear advantages: it is more efficacious; it can be used up to five days after intercourse; and there is no age restriction on OTC sale. Despite falling numbers of teenage pregnancies, the UK still has one of the highest rates in western Europe.³ Termination rates are also increasing in the over-35s.

Community pharmacy teams have a vital role to play in providing confidential support and advice in a safe environment, without the need for an appointment, to anyone of any age wishing to prevent an unwanted or unintended pregnancy. There is clear evidence that pharmacists, their teams and locums are keen to get more involved, if attendance at a series of seven training workshops run by HRA Pharma, the manufacturer of ellaOne, is anything to go by.

After undergoing the training, research indicated that attendees had a better understanding of the product benefits, felt far more confident about recommending it and had a deeper insight into how to deal with requests for EHC in a sensitive and patient-focused manner. Some 97 per cent of attendees found the seminars useful or extremely useful. This commitment to pharmacy education, investment in time and resources seems to be paying off for the company.

While it is too early to tell if sales reflect this, the distribution and widespread availability of ellaOne are certainly on track. For pharmacists who didn’t attend a workshop, an online training resource has been developed with webinars from the training events including interactive scenarios, training and consultation support materials, available to download.

This can be accessed at the ellaOne website by clicking through to the ‘Training Resources’ link at the top of the page. The website also has a wealth of information about unintended pregnancies, reproductive physiology, as well the role of the pharmacy team in providing EHC, and some useful case studies.

Effective engagement

It is sometimes easy to forget that asking for EHC can be daunting for some women. In a recent EU survey, 50 per cent of women said they found seeking EHC embarrassing. But it is the women who ask for emergency contraception who are behaving responsibly by taking steps to avoid unintended pregnancy.

It may be an emotional time for them, so it is important for pharmacy teams to offer a welcoming, confident, positive and professional approach to make them feel comfortable. Part of this is ensuring that medicines counter assistants know how to engage appropriately with such customers to ensure they have a positive experience.

Discretion is important, so it might be useful to offer the patient the option of a more private place to talk (e.g. in the consultation room). Assistants also need to know that the pharmacist has to be involved in the process.

You might find that practising patient interactions using role play will help build your team’s confidence so they can deal with requests for emergency contraception professionally, making the process of obtaining EHC easier and less embarrassing. In terms of talking to the patient, components of effective counselling include:

• Listening
• Being matter-of-fact
• Reassuring the person that they have done the right thing
• Use the patient’s language (refer to the “morning-after pill” or “day-after pill”, instead of EHC).

Other considerations include:

• Explaining how the medicine works
• Encouraging the person to take it as soon as possible
• Explaining that barrier contraception should be used until the next period
• If the person vomits within three hours of taking the tablet, they should take another one
• It can affect periods, making them earlier or later than normal. Pharmacists may also feel it appropriate to provide advice about safe sex.

Interestingly, the factors women take into account Pharmacy teams are embracing the opportunity to make a difference with a new emergency contraception medicine EHC launch puts pharmacy in the spotlight when choosing EHC in order of importance are: effectiveness, pharmacist advice and recommendation, window of use, sideeffects and, finally, price.

Many benefits

EllaOne is an example of a wellplanned and supported product launch that has clear benefits for pharmacy, the NHS and, importantly, for women of all ages who choose to seek help in avoiding unwanted pregnancies. If you haven’t already completed the training, make sure you and your staff are confident about the benefits that ellaOne has to offer and can explain them to women who ask for your advice during what can be a very stressful time for them.

 

 

• References available from the Editor on request