Emergency hormonal contraception dispensing patterns in Shropshire pharmacies: an epidemiological analysis

Problem

Many women each year require access to emergency hormonal contraception (EHC). In rural areas across England, such as the county of Shropshire, pharmacies often provide the most consistent access to this form of emergency contraception. Women attending pharmacies for EHC do not have access on-site to the full range of related sexual health and contraceptive services, and importantly do not have ready access to the most effective form of emergency contraception, the intrauterine device (IUD). Women attending pharmacies may also be attending repeatedly and require further comprehensive assessment. It is imperative, therefore, to fully understand the demographics of women attending pharmacies for EHC in order to tailor services effectively, and ensure pharmacists are providing the most accurate information for the potential ongoing contraceptive and sexual health needs of this vulnerable group of women.

Approach

This retrospective descriptive epidemiological analysis was conducted using routine anonymised PharmOutcomes data collected from all EHC dispensing pharmacies within Shropshire local authority boundaries during the period of 1st April 2016 to 31st January 2019. Patients attending for EHC were described by age, ethnicity, reason for attendance, prior known use of EHC, acceptance of referral for IUD and type of EHC prescribed. Those women identified as repeatedly attending pharmacies for EHC dispensing were separately described with respect to the same characteristics as above and compared to the women attending just once during that time period.

Findings

3499 attendances, by 3079 individual women, were seen during the period 01/04/16 to 31/01/19 across all Shropshire pharmacies signed up to the EHC dispensing contract with Shropshire Council’s sexual health commissioning service. This study remains ongoing, with further preliminary results expected by the end of February 2019, and full results by the end of March 2019.

Consequences

This descriptive analysis aims to fully understand which women Shropshire attend pharmacies to access EHC. In describing their characteristics, and considering those who attend repeatedly in more detail, I hope to outline key aspects of care that can be further explored to ensure that the most safe and effective services are provided to vulnerable women in Shropshire who require emergency contraception. This information should be utilised by local authorities and clinical commissioning groups in providing accessible and effective emergency contraceptive services across Shropshire, and also in geographically similar counties across England.