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Pharmacist interventions prevent pregnancy after EHC

Community pharmacist interventions result in a “clinically meaningful” increase in effective use of a contraceptive pill following emergency hormonal contraception, a recent study indicates.

The study, published in The Lancet on November 14, recruited 636 women as part of a cluster-randomised trial involving 29 pharmacies in London and across Scotland.

Around half of the women who presented at the pharmacy for EHC were given a three-month supply of the progestogen-only pill and given a rapid access card for their local sexual and reproductive health clinic, while the remaining half were advised to see their usual contraceptive provider.

Follow-up data was available for 406 of the participants. It showed that after four months the proportion of women using effective contraception was almost 20 per cent higher in the pharmacist intervention group (mean 58.4 per cent) than in the control group (mean 40.5 per cent).

“Provision of a supply of the progestogen-only pill with emergency contraception from a community pharmacist, along with an invitation to a sexual and reproductive health clinic, results in a clinically meaningful increase in subsequent use of effective contraception,” say the authors.

“Widescale implementation of this simple and safe intervention is now indicated and should be expected to reduce the rates of unintended pregnancy after emergency contraception.”

The authors say that as the study included both a mix of chain pharmacies and independents who provide EHC at a high volume, “the results are probably generalisable to UK pharmacies in which most emergency contraception is provided”.

While the majority of women who access EHC do so from a community pharmacy, for ongoing contraception “pharmacists can generally only provide barrier methods which have high failure rates,” the authors note.

This is despite the fact that to prevent pregnancy after EHC use, women must start “an effective method of ongoing contraception”.

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