Pharmacists tackle teenage pregnancy
PHARMACISTS in East Kent are tackling the problem of
teenage pregnancy through the introduction of a patient group direction
to supply emergency hormonal contraception. Under the PGD, launched on
2 July, women aged below 20 years can obtain Levonelle-2 free from designated
pharmacies.
Amanda Harrison, teenage pregnancy co-ordinator,
East Kent Health Authority, said that the PGD differed from others for
EHC in that it is targeted specifically at young people. A local media
campaign to promote the service will begin on 9 July and, in the long
term, this might include promotion through schools.
Since the introduction of over-the-counter Levonelle-2,
many pharmacists have noted that it tends to be purchased by older women.
The East Kent PGD aims to encourage younger women to access emergency
contraception through the pharmacy. “The PGD allows the involvement of
another health care professional in getting services to young people,”
said Ms Harrison. “It makes the most of pharmacists’ skills and their
accessibility,” she added.
The inclusion criterion for the East Kent PGD is:
“Women below the age of 20 presenting at the pharmacy within 72 hours
of the earliest episode of unprotected sexual intercourse.” It notes that
in exceptional circumstances, women aged over 20 years can be supplied
with Levonelle-2 if they are unable to obtain a supply from another source
before the 72 hours expires.
In order to make a supply to a patient who appears
to be under 16 years of age, the pharmacist must determine that the patient
is Gillick competent (see Panel). If the patient is judged not to be Gillick
competent, the pharmacist should not make a supply but refer the patient
to a family planning doctor or general practitioner.
If Levonelle-2 is supplied, the pharmacist should
advise the patient to have a follow-up appointment with a family planning
clinic or GP after three or four weeks to ensure that the EHC has worked
and to discuss on-going contraception.
Patients supplied with Levonelle-2 are given an
information sheet about the treatment including advice about what to do
if they vomit after taking a tablet. Part of the consultation also involves
a discussion about ongoing contraception and sexually transmitted diseases,
including information about the availability of local family planning
clinics and genitourinary medicine clinics. Every patient who accesses
the service, regardless of whether or not they are supplied EHC, is given
a supply of condoms to address the potential risk of STDs.
Four or five pharmacies in each primary care group
across East Kent are participating in the PGD. Pharmacies that are not
involved will give the telephone number of an information line to patients
that will inform them of the nearest participating pharmacy. All participating
pharmacists have received training in issuing EHC including completing
a Centre for Pharmacy Postgraduate Education package and attending a training
course. In addition, each pharmacist has been visited by a PCG pharmacist
to ensure they are happy with the service arrangements. Training must
be updated every two years.
Pharmacists must carry out each consultation themselves
and make records of every consultation and its outcome. Records have to
be kept for eight years if the client is believed to be over 16 years
or until the client’s 26th birthday if they are believed to be under 16
years. Pharmacists are paid a fee of £10 by the health authority for each
consultation, regardless of whether or not Levonelle-2 is supplied, and
are reimbursed for the cost of the drug. To claim payment, pharmacists
must submit monitoring forms that include information about who is using
the services, why and the outcomes of consultations. Patients do not need
to give their name, and data are assessed according to the patient’s locality
and date of birth if it has been obtained.
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