Wong Karen, Hum Susan, McCarthy Lisa, Dunn Sheila
Faculty of Medicine, University of Toronto, Toronto, ON.
Women's College Research Institute, Women's College Hospital, Toronto, ON.
J Obstet Gynaecol Can. 2017 Nov;39(11):1021-1027. doi: 10.1016/j.jogc.2017.04.042. Epub 2017 Jul 28.
Pharmacists are often the front-line health care providers for women seeking emergency contraception (EC). This study explored Ontario pharmacists' EC counselling practices and their perceived barriers to recommending the most effective EC method, the copper IUD (Cu-IUD).
This qualitative study used one-on-one, semistructured interviews with 20 pharmacists working in pharmacies located within a 1-km radius of a large sexual health clinic that offered postcoital IUDs in downtown Toronto.
All pharmacists provided counselling about levonorgestrel (LNG-EC), and all considered it important. Nevertheless, they rarely discussed the Cu-IUD, even in circumstances where LNG-EC could be less effective, such as delayed presentation or for women with BMI >25 kg/m. Some pharmacists felt conflicted in their dual roles as health care and customer service provider when counselling about and selling EC, and many felt uncomfortable discussing body weight. Pharmacists were not well informed about the Cu-IUD. They identified many pharmacist-specific barriers to counselling about the Cu-IUD for EC, as well as health systems issues around Cu-IUD provision and insertion.
Ontario pharmacists embraced their role in EC counselling, yet their discussions rarely included the most effective Cu-IUD option. Educating and training pharmacists about the Cu-IUD and establishing referral pathways for IUD insertion could expand their counselling about this EC option.
药剂师往往是寻求紧急避孕（EC）的女性的一线医疗服务提供者。本研究探讨了安大略省药剂师的紧急避孕咨询实践，以及他们在推荐最有效的紧急避孕方法——铜宫内节育器（Cu-IUD）时所感知到的障碍。
这项定性研究采用一对一的半结构化访谈，对象是在多伦多市中心一家提供性交后宫内节育器的大型性健康诊所半径1公里范围内的药店工作的20名药剂师。
所有药剂师都提供了关于左炔诺孕酮（LNG-EC）的咨询，并且都认为其很重要。然而，他们很少讨论铜宫内节育器，即使在LNG-EC可能效果较差的情况下，如就诊延迟或体重指数（BMI）>25kg/m²的女性。一些药剂师在提供紧急避孕咨询和销售紧急避孕药物时，对自己作为医疗服务提供者和客户服务提供者的双重角色感到矛盾，许多人对讨论体重感到不自在。药剂师对铜宫内节育器了解不足。他们确定了许多药剂师在为紧急避孕咨询铜宫内节育器时特有的障碍，以及围绕铜宫内节育器供应和插入的卫生系统问题。
安大略省的药剂师认可他们在紧急避孕咨询中的作用，但他们的讨论很少包括最有效的铜宫内节育器选项。对药剂师进行关于铜宫内节育器的教育和培训，并建立宫内节育器插入的转诊途径，可能会扩大他们对这种紧急避孕选项的咨询。
