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The Pharmaceutical Journal Vol 263 No 7068 p665
October 23, 1999 Clinical

Majority of pharmacists favour OTC emergency contraception, survey finds

The majority of pharmacists would be willing to supply emergency contraception over the counter if it were deregulated from POM to P legal status, a survey has shown. Seventy five per cent of respondents stated a willingness to be involved. However, more than half of this group said that they would need specific training before offering such a service. Although concerns were raised, these were mainly related to safety issues, with few pharmacists identifying moral and ethical barriers to deregulation.
The questionnaire survey was carried out by pharmacist Keith Holden (Durham and Teesside Pharmacy Practice Unit), with colleagues from the University of East Anglia and University of Sunderland. It is published in the British Journal of Family Planning (October 15). Questionnaires were sent to 3,999 pharmacists in Great Britain, 1,543 of whom responded. Questions included concerns about current practice, willingness to supply emergency contraception if it were to be deregulated and the perceived advantages and disadvantages of deregulation.

photo of Schering PC4
Many pharmacists said that they would need specific training before supplying OTC emergency contraception

Sixty-two per cent of respondents were community pharmacists and 77 per cent worked in an environment where emergency contraception could be supplied. Of these, 96 per cent currently dispensed prescriptions for emergency contraception and 0.7 per cent (10 respondents) did not supply, exercising the professional conscience clause. Twenty-five per cent of respondents were unwilling to supply deregulated emergency contraception for a number of reasons, of which 53 per cent were safety or training concerns and 22 per cent were moral and ethical reasons.
The major benefits of deregulation were seen as being a reduced unwanted pregnancy rate and reduced abortion rate. Many respondents felt that supply through pharmacies would result in easier and quicker access to emergency contraception. Other perceived benefits included helping to raise the profile of the profession, reducing the burden on GPs and anonymity. Seven per cent of respondents (173) thought there was no major benefit in deregulating emergency contraception and 0.6 per cent (16) felt there was no need for deregulation.
Only 93 pharmacists (3 per cent) had no concerns regarding deregulation. Concerns expressed were predominantly in clinical and public health areas. Respondents were concerned that emergency contraception could be abused, perhaps through use as a regular method of contraception. A lack of access to medical histories, a fear of contraindications and a lack of monitoring and follow-up were other concerns. The procedures involved in supplying emergency contraception were also of concern, including a lack of pharmacist training, a lack of counselling and pharmacists being too busy to provide the service. Two per cent were fearful of litigation.
Dr Neil Cooper (University of East Anglia school of nursing and midwifery), one of the study authors said: "There has been a vocal minority of pharmacists speaking out against deregulation. We found that the overwhelming majority of the 1,500 we surveyed were in favour of supplying it themselves. This represents a real groundswell towards making [emergency contraception] more widely available."

See also p678