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Beyond Plan B: A look into pharmacists’ emergency contraceptives counselling practices

September 25, 2017

By Anne Coffey

This article is in recognition of World Contraception Day on September 26.

Due to time-sensitivity and accessibility, pharmacists are often the front-line healthcare providers for women seeking emergency contraception.

However, according to a recent study published in the Journal of Obstetrics and Gynaecology Canada, pharmacists experience some barriers to discussing a full range of emergency contraceptives options with women.

Dr. Karen Wong, University of Toronto medical student at the time of the study, supported by Women’s College Research Institute’s (WCRI) Dr. Sheila Dunn, Susan Hum, MSc, and Lisa McCarthy, PharmD, conducted a qualitative study with 20 Ontario pharmacists in order to understand their emergency contraception counselling practices and perceived barriers to recommending the most effective method, the copper intrauterine device (IUD).

The copper IUD is the most effective emergency contraception method with an effectiveness rate of 99 per cent and can also be left in place to provide ongoing birth control. However, most women know only about the Plan B® pill, which is actually less effective than the copper IUD, especially if there is a delay in getting emergency contraception or if a woman weighs more than
75 kg / 165 lb.

If the copper IUD is more effective for emergency contraception, why aren’t more pharmacists recommending them to their patients? According to the study, barriers to pharmacists’ counselling on copper IUD for emergency contraception included limited knowledge and misperceptions about IUDs, as well as health system issues around IUD provision and insertion. Overall, pharmacists felt that the copper IUD for emergency contraception was inconvenient, as one pharmacist stated, “It’s a little harder to do emergency IUD because you still have to find someone to do the insertion.”

“As pharmacists, since we cannot insert IUDs ourselves, the extra step may prevent some from recommending IUDs as an option,” says Dr. McCarthy. “It’s definitely a perceived barrier.”  

The study concluded that pharmacists would like more education about copper IUD and health care pathway solutions to expedite timely copper IUD insertion.

To learn more about what Women’s College Hospital is doing to close the Health Gaps click here.


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