Emergency contraception in Australian community pharmacies: a simulated patient study

Abstract

Background Australia joined the worldwide movement to increase the availability of the emergency contraceptive pill (ECP) by rescheduling from Prescription to Pharmacist Only status in 2004. However a protocol developed to aid in the provision of the ECP placed extensive requirements on the pharmacist. This study investigated the provision of the ECP by community pharmacists in Sydney, Australia. Study Design Using a simulated patient methodology, 100 community pharmacies were visited over a five week period (Aug–Oct 2008). The simulated patient specifically requested the ECP, and details of the consultation were recorded on a standardised data collection form. Results The ECP was supplied in 95% of the pharmacies visited. Patient privacy was observed in 90% of consultations, which in general were succinct and friendly. Clinical assessment of the patient that met all the requirements was observed in 18%, partial assessment in 69%, and inadequate assessment in 13% of consultations. Provision of required information to the patient was sufficient in 42%, partial in 55%, and inadequate in 3% of consultations. Conclusions This study highlighted a need to standardize procedures in regard to the ECP service to present a more consistent level of service to the public. Suggestions to improve the service include complete revision and simplification of the current protocol and improved training. Additionally, mandatory provision of private consultation areas and continuing professional education may facilitate and enhance quality counselling.