Boog Katie, Chen Zhong Eric, Cameron Sharon
Fife Sexual Health Service, Whytemans Brae Hospital, Kirkcaldy, United Kingdom
Chalmers Centre, Edinburgh, UK.
BMJ Sex Reprod Health. 2019 Jun 1. doi: 10.1136/bmjsrh-2018-200252.
Reduced funding to contraceptive services in the UK is resulting in restricted access for women. Pharmacists are already embedded in sexual and reproductive health (SRH) care in the UK and could provide an alternative way for women to access contraception. The aim of this study was to determine the views of UK contraception providers about community pharmacist-led contraception provision.
An anonymous questionnaire was distributed to healthcare professionals at two UK SRH events, asking respondents about: (1) the use of patient group directions (PGDs) for pharmacist provision of oral contraception (OC); (2) the sale of OC as a pharmacy medicine or general sales list medicine; (3) the perceived impact of pharmacy provision of OC on broader SRH outcomes; and (4) if other contraceptive methods should be provided in pharmacies.
Of 240 questionnaires distributed, 174 (72.5%) were returned. Respondents largely supported pharmacy-led provision of all non-uterine methods of contraception, excluding the contraceptive implant. Provision of the progestogen-only pill by PGD was most strongly supported (78% supported initiation). Respondents felt that the use of bridging (temporary) contraception would improve (103/144, 71.5%), use of effective contraception would increase (81/141, 57.4%), and unintended pregnancies would decline (71/130, 54.6%); but that use of long-acting reversible contraception would decrease (86/143, 60.1%). Perceived barriers included pharmacists' capacity and competency to provide a full contraception consultation, safeguarding concerns, and women having to pay for contraception.
UK SRH providers were largely supportive of community pharmacy-led provision of contraception, with training and referral pathways being required to support contraception delivery by pharmacists.
英国用于避孕服务的资金减少，导致女性获得避孕服务的机会受限。药剂师已融入英国的性与生殖健康（SRH）护理体系，可为女性提供另一种获取避孕措施的途径。本研究的目的是确定英国避孕服务提供者对社区药剂师主导的避孕服务的看法。
在英国的两次SRH活动中，向医疗保健专业人员发放了一份匿名问卷，询问受访者关于：（1）使用患者群体指导（PGD）让药剂师提供口服避孕药（OC）；（2）将OC作为药房药品或一般销售清单药品出售；（3）药房提供OC对更广泛的SRH结果的感知影响；以及（4）药房是否应提供其他避孕方法。
在发放的240份问卷中，有174份（72.5%）被收回。受访者大多支持由药剂师主导提供除避孕植入剂外的所有非子宫避孕方法。通过PGD提供仅含孕激素的避孕药得到了最强烈的支持（78%支持开始提供）。受访者认为使用过渡性（临时）避孕措施会有所改善（103/144，71.5%），有效避孕措施的使用会增加（81/141，57.4%），意外怀孕会减少（71/130，54.6%）；但长效可逆避孕措施的使用会减少（86/143，60.1%）。感知到的障碍包括药剂师提供全面避孕咨询的能力和资质、安全保障问题以及女性需要自费购买避孕用品。
英国的SRH服务提供者大多支持社区药房主导的避孕服务，但需要培训和转诊途径来支持药剂师提供避孕服务。
