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Title: The morning-after pill [letter]
Author: Abell S
Source: Clinical Pediatrics. 2009 Apr;48(3):341-2; discussion 342.
Abstract: This is a question from a reader to the journal's Medical Doctor about the morning-after pill. The Dr. clearly confirms that the morning-after pill is not causing abortion. Her description helps us better understand how this pill (usually levonorgestrel), a progestin, works in preventing a pregnancy. This approach, which is now known as Plan B™, has received strong support in the prevention of unplanned pregnancies from both the American College of Obstetrics and Gynecology and the American Academy of Pediatrics in also circumventing the need for abortions in women of all ages, especially in adolescent girls. Some pharmacists have resisted filling these Plan B prescriptions, so it will be important for pediatricians to know which pharmacies in your community will accept your Plan B™ prescriptions. Sadly, teenage pregnancies continue to have a major impact on disadvantaged teenagers. This group of individuals also may have limited access to Plan B prescriptions, which requires that they should be taken within 5 days of unprotected intercourse in order for them to be effective in preventing unwanted pregnancies.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | EVALUATION | WOMEN | EMERGENCY CONTRACEPTION | CONTRACEPTIVE MODE OF ACTION | ABORTION | CONTRACEPTIVE SAFETY | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | ORAL CONTRACEPTIVES, SIDE EFFECTS | NAUSEA | VOMITING | Developed Countries | North America | Americas | Demographic Factors | Population | Contraception | Family Planning | Fertility Control, Postconception | Safety | Public Health | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Signs and Symptoms | Diseases
Document Number: 331244 Notification

Peer Reviewed

Title: Pharmacy worker practices related to use of misoprostol for abortion in one Mexican state.
Author: Billings DL; Walker D; Mainero del Paso G; Clark KA; Dayananda I
Source: Contraception. 2009 Jun;79(6):445-51.
Abstract: BACKGROUND: Pharmacies are important sites for access to health information and medications in Mexico. Most workers are not trained in health issues and may provide inaccurate information to consumers. Misoprostol is used by women throughout Mexico for early abortion and often is purchased from pharmacies. This study aims to understand the practices of pharmacy workers when asked for advice about and medications for abortion, in particular misoprostol. STUDY DESIGN: A random sample of pharmacies in both urban and rural areas of one state of Mexico included both chain and independent pharmacies (n=169). Two mystery clients (MCs) visited the pharmacies, requesting medication for "bringing down the period" and then asking for misoprostol. MCs recorded information about the interactions following each visit in standardized formats. Bivariate comparisons were made between spontaneous and prompted discussions of misoprostol. Associations were considered statistically significant at alpha<.05. RESULTS: Ninety percent of pharmacy workers attending to the MCs discussed misoprostol as an abortifacient, either spontaneously or after being prompted by the MCs. Misoprostol was for sale in most (61%) of these pharmacies. The majority of pharmacy workers (75%) did not request a prescription. Over 75% of all pharmacy workers provided the MCs referral to trained medical providers with whom they could seek a follow-up visit. Sixteen percent of pharmacy workers suggested a regimen consistent with evidence and recommendations for using misoprostol for early abortion. Regimens that were underdosages were common, and few workers recommended a potentially harmful overdosage. Instructions about side effects and risks were rare. The price of misoprostol ranged from 900 to 1800 pesos (US$83-167) for a bottle of 28 tablets (200 mcg each) or US$4.07 per tablet, on average. CONCLUSIONS: Pharmacy workers in both urban and rural areas of Mexico are increasingly becoming aware of misoprostol as an effective abortifacient and are willing to provide the information to consumers. However, their information is limited and often inaccurate. Strategies need to be developed so that they receive timely and correct information, consistent with evidence-based recommendations. The legal context of abortion in Mexico (with restrictions in every state, except Mexico City), the restricted registration of misoprostol as a therapeutic agent only for gastric ulcers and the fact that the majority of pharmacy workers are not considered to be health workers are among the most important barriers to advances in training pharmacy workers in the correct application of misoprostol.
Language: English
Keywords:
MEXICO | RESEARCH REPORT | CLIENTS | PHARMACY DISTRIBUTION | MISOPROSTOL | ABORTION | INFORMED CHOICE | INFORMATION | North America | Americas | Developing Countries | Program Activities | Programs | Organization and Administration | Nonclinical Distribution | Distributional Activities | Prostaglandins, Synthetic | Prostaglandins | Endocrine System | Physiology | Biology | Fertility Control, Postconception | Family Planning | Contraceptive Usage | Contraception
Document Number: 342599 Notification

Peer Reviewed

Title: Involving pharmacists in sexual health research: experience from an emergency contraception study.
Author: Black K; Anderson C; Kubba A; Wellings K
Source: Journal of Family Planning and Reproductive Health Care. 2009 Jan;35(1):41-3.
Abstract: BACKGROUND: Community pharmacists are expanding their sphere of activity within primary health care, increasing their role not only in health care but also research. METHODS AND RESULTS: We describe the challenges encountered in carrying out a pilot study of women obtaining emergency hormonal contraception through different providers, including pharmacies, highlighting deficiencies in understanding and experience of the research process, which impacted on the study in substantial ways. CONCLUSIONS: As pharmacists expand their role, training and professional development will need to be enhanced to support them in their contribution to health care and research.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | EMERGENCY CONTRACEPTION | PHARMACISTS | EDUCATION | HOME CARE | PHARMACY DISTRIBUTION | SEX EDUCATION | HEALTH | RESEARCH AND DEVELOPMENT | Developed Countries | Europe, Western | Europe | Contraception | Family Planning | Health Personnel | Delivery of Health Care | Care and Support | Health Services | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Technology | Economic Factors
Document Number: 329636

Peer Reviewed

Title: Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK : a prospective study.
Author: Brabin L; Thomas G; Hopkins M; O'Brien K; Roberts SA
Source: BMC Women's Health. 2009 Mar 26;9(1):7.
Abstract: ABSTRACT: BACKGROUND: More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. METHODS: Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers ([greater than or equal to] 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. RESULTS: 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348 /2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). CONCLUSIONS: Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | YOUTH | SCREENING | EMERGENCY CONTRACEPTION | CHLAMYDIA | PHARMACY DISTRIBUTION | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Age Factors | Population Characteristics | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraception | Family Planning | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 330849

Peer Reviewed

Title: Adherence to first-line antiretroviral therapy affects non-virologic outcomes among patients on treatment for more than 12 months in Lusaka, Zambia.
Author: Chi BH; Cantrell RA; Zulu I; Mulenga LB; Levy JW; Tambatamba BC; Reid S; Mwango A; Mwinga A; Bulterys M; Saag MS; Stringer JS
Source: International Journal of Epidemiology. 2009 Jun;38(3):746-56.
Abstract: BACKGROUND: High-level adherence to antiretroviral therapy (ART) is associated with favourable patient outcomes. In resource-constrained settings, however, there are few validated measures. We examined the correlation between clinical outcomes and the medication possession ratio (MPR), a pharmacy-based measure of adherence. METHODS: We analysed data from a large programmatic cohort across 18 primary care centres providing ART in Lusaka, Zambia. Patients were stratified into three categories based on MPR-calculated adherence over the first 12 months: optimal (> or =95%), suboptimal (80-94%) and poor (<80%). RESULTS: Overall, 27 115 treatment-naive adults initiated and continued ART for > or =12 months: 17 060 (62.9%) demonstrated optimal adherence, 7682 (28.3%) had suboptimal adherence and 2373 (8.8%) had poor adherence. When compared with those with optimal adherence, post-12-month mortality risk was similar among patients with sub-optimal adherence [adjusted hazard ratio (AHR) = 1.0; 95% CI: 0.9-1.2] but higher in patients with poor adherence (AHR = 1.7; 95% CI: 1.4-2.2). Those <80% MPR also appeared to have an attenuated CD4 response at 18 months (185 cells/microl vs 217 cells/microl; P < 0.001), 24 months (213 cells/microl vs 246 cells/microl; P < 0.001), 30 months (226 cells/microl vs 261 cells/microl; P < 0.001) and 36 months (245 cells/microl vs 275 cells/microl; P < 0.01) when compared with those above this threshold. CONCLUSIONS: MPR was predictive of clinical outcomes and immunologic response in this large public sector antiretroviral treatment program. This marker may have a role in guiding programmatic monitoring and clinical care in resource-constrained settings.
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | CLINICAL RESEARCH | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | CLIENTS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | IMMUNOLOGICAL EFFECTS | PHARMACY DISTRIBUTION | MORTALITY | HEMOGLOBIN LEVEL | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | HIV | Behavior | Immunity | Immune System | Physiology | Biology | Nonclinical Distribution | Distributional Activities | Population Dynamics | Demographic Factors | Population | Hemic System
Document Number: 342460

Title: Self-reported sexually transmitted disease symptoms and treatment-seeking behaviors in China.
Author: Guan J; Wu Z; Li L; Lin C; Rotheram-Borus MJ; Detels R; Hsieh J
Author: NIMH Collaborative HIV/STD Prevention Trial Group
Source: AIDS Patient Care and STDs. 2009 Jun;23(6):443-8.
Abstract: In recent decades, sexually transmitted diseases (STDs) have reemerged and spread as a major public health problem in China. However, little effort has been made on promoting appropriate health-seeking behaviors among people living with STDs. A randomly selected sample of market vendors in Fuzhou (N = 4510) was recruited and assessed from 2003 to 2004 to examine their choice of pharmacy versus hospital, and folk remedy versus Western medicine when having STD symptoms. Approximately 11.3% of the sample (4.0% of men and 17.8% of women) reported having had abnormal genital discharge or genital ulcer during the past 6 months. More (over 60%) people chose Chinese folk remedy to treat symptoms or prevent transmission when they had genital discharge and/or genital ulcer. Approximately 30% of study participants with reported STD symptoms visited pharmacies only to seek treatment, and 17% visited neither hospital nor pharmacies. Visiting a pharmacy only for STD treatment was marginally significantly associated with being female (prevalence ratio [PR] = 1.665, confidence interval [CI] = 0.980, 2.831) and never married (PR = 1.984, CI = 1.098, 3.594) after controlling for other potential confounders. Education about appropriate health-seeking behaviors to obtain effective treatment of STD must be a top priority to control the rapid spread of STDs in China.
Language: English
Keywords:
CHINA | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | SEXUALLY TRANSMITTED DISEASES | TREATMENT | TRADITIONAL HEALTH PRACTICES | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | PHARMACY DISTRIBUTION | Asia, Eastern | Asia | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Reproductive Tract Infections | Infections | Diseases | Medical Procedures | Medicine | Delivery of Health Care | Health | Culture | Sociocultural Factors | Nonclinical Distribution | Distributional Activities
Document Number: 342431

9.
Title: [Providing emergency contraceptive pills in pharmacies]
Author: Heidarsdottir ML; Almarsdottir AB; Geirsson RT
Source: Laeknabladid. 2009 May;95(5):343-347.
Abstract: Objective: Use of the levonorgestrel emergency contraception (EC) pill has become more common after being made formally available in pharmacies without prescription. It was investigated how pharmacists in the capital area of Reykjavik supply EC to clients. Material and methods: A total of 46 pharmacists of all working ages and both genders were asked to answer a questionnaire concerning how they sold the emergency contraception pill over the counter (84.8% reply rate). Results: Four of five used <5 minutes to discuss emergency contraception with the client, but almost all enquired about time from intercourse. While only 20% asked about the woman s health, most considered concomitant drug use and potential interaction with levonorgestrel. Only about 50% pointed out that EC did not protect against sexually transmitted disease, (3/4) pointed out the need for permanent contraceptive use, 95% asked about previous EC use, but only 30% would provide EC again in the same menstrual cycle. One half of the pharmacists sold EC to men/teenage boys and wished to assist them with taking responsibility, while the others only sold the drug to the woman. Of those prepared to give the drug to the men, 55% asked to speak over the telephone with the woman to ensure correct prescription and information. Nearly a third would never or rarely provide consultation in private. Conclusions: Pharmacists agree mostly about main points in supplying EC, but not as regards provision to women through their male partners. Provisons for consultation can be improved. Key words: Key contraception, emergency contraception, pregnancy. Correspondence: Reynir Tomas Geirsson, reynirg@landspitali.is.
Language: Icelandic
Keywords:
RUSSIA | RESEARCH REPORT | QUESTIONNAIRES | WOMEN | SEXUAL PARTNERS | EMERGENCY CONTRACEPTION | PREGNANCY | PHARMACY DISTRIBUTION | Developing Countries | Asia, Northern | Asia | Demographic Factors | Population | Sex Behavior | Behavior | Contraception | Family Planning | Reproduction | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 341070

10.
Title: Knowledge of emergency contraception among women of childbearing age at a teaching hospital of Karachi.
Author: Irfan F; Karim SI; Hashmi S; Ali S; Ali SA
Source: JPMA. Journal of the Pakistan Medical Association. 2009 Apr;59(4):235-40.
Abstract: OBJECTIVES: To assess knowledge and attitudes about Emergency Contraception among women of childbearing age in Karachi, Pakistan. METHODS: A questionnaire based survey was conducted on 400 married women, attending the family practice clinics at a teaching hospital in Karachi, Pakistan from July to December 2006. Questionnaire was administered to women at the family practice clinic-seeking level of knowledge of emergency contraception (EC) and attitudes towards its use, Ethical requirements of informed consent and confidentiality were ensured Data was entered into Epi data and analyzed in SPSS. RESULTS: Eighty-eight percent of women were not aware of EC. 83% were housewives. Only a small number (11.5%) ever used EC to prevent pregnancy, out of those, the correct timing of effectiveness of post-coital pill was known to only 40% of women while none of these women were aware of the existence of Intra Uteriune Contraceptive Device (IUCD) insertion as an option for EC About 50% of women identified general practitioners or family medicine clinics as their main sources of knowledge about EC. Increased advertising was considered desirable by 72% while 37% considered over the counter availability of EC pill desirable and only 36% of women were uncomfortable to use EC because of religious reasons. CONCLUSION: EC has a potential to offer women an important option for fertility control. Lack of women's knowledge about EC use and availability may account in part for its limited use. There is a need to improve women's education about EC. The primary health care providers can play a major role in informing their patients about emergency contraception.
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | KAP SURVEYS | WOMEN IN DEVELOPMENT | KNOWLEDGE | EMERGENCY CONTRACEPTION | ATTITUDES | TIME FACTORS | CONTRACEPTIVE USAGE | IUD | ADVERTISING | PHARMACY DISTRIBUTION | CONTRACEPTIVE AVAILABILITY | RELIGION | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Sociocultural Factors | Contraception | Family Planning | Psychological Factors | Behavior | Population Dynamics | Demographic Factors | Population | Contraceptive Methods | Promotion | Marketing | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 331281

11.

Title: Pharmacist interest in and attitudes toward direct pharmacy access to hormonal contraception in the United States.
Author: Landau S; Besinque K; Chung F; Dries-Daffner I; Maderas NM; McGhee BT; Foster DG
Source: Journal of the American Pharmacists Association. 2009 Jan-Feb;49(1):43-50.
Abstract: OBJECTIVES: To assess pharmacist interest, comfort level, and perceived barriers regarding providing pharmacist-initiated access to hormonal contraceptives (i.e., tablets, patches, rings, injectables, emergency contraception [EC]). DESIGN: Descriptive, nonexperimental, cross-sectional study. SETTING: United States between November 2004 and January 2005. PARTICIPANTS: 2,725 pharmacists working in community chain pharmacies (64%), community independent pharmacy (31%), and other practice settings, including hospitals and home care facilities (5%). INTERVENTION: Survey sent electronically by the American Pharmacists Association to a random sample of 14,142 of its 50,000 pharmacist members nationally. MAIN OUTCOME MEASURES: Pharmacist interest and comfort level in providing pharmacy access to hormonal contraception (HC), perceived barriers and training needs, and familiarity with and provision of EC. RESULTS: 2,725 survey responses (19% response rate) were received. Pharmacists reported being very familiar with HC. The majority of respondents were comfortable and interested in providing direct access to HC in the pharmacy. Perceived barriers to providing HC in the pharmacy included lack of time, no mechanism of reimbursement for the service, and possible resistance from physicians. CONCLUSION: Strong interest, comfort level, and capability from pharmacists, combined with a documented demand for direct pharmacy access from patients, indicate that pharmacy access to HC has the potential to meet patient needs and increase access to HC. Education about current clinical practice recommendations-which no longer require pelvic examinations and Papanicolaou (Pap) smears before hormonal contraception is initiated-may increase pharmacist support for providing hormonal methods directly.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | PHARMACISTS | HORMONES | CONTRACEPTIVE AGENTS | ATTITUDES | PERCEPTION | CONTRACEPTIVE DISTRIBUTION | PHARMACY DISTRIBUTION | ON-THE-JOB TRAINING | NEEDS ASSESSMENT | TIME FACTORS | ECONOMIC FACTORS | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Health Personnel | Delivery of Health Care | Health | Endocrine System | Physiology | Biology | Contraception | Family Planning | Psychological Factors | Behavior | Distributional Activities | Program Activities | Programs | Organization and Administration | Nonclinical Distribution | Training Programs | Education | Evaluation | Population Dynamics | Demographic Factors | Population
Document Number: 330051

12.

Peer Reviewed

Title: Emergency contraceptive use among 5677 women seeking abortion in Shanghai, China.
Author: Meng CX; Gemzell-Danielsson K; Stephansson O; Kang JZ; Chen QF; Cheng LN
Source: Human Reproduction. 2009 Apr 9;1(1):1-7.
Abstract: BACKGROUND The increasing use of emergency contraceptive pills (ECPs) does not seem to reduce the number of induced abortions as would be expected, indicating that women use ECPs might also be a strong factor affecting their final efficacy. The study aimed to understand the attitude towards, and use of, ECPs among women seeking an abortion. METHODS A cohort study was conducted via face-to-face questionnaire interview among women seeking abortion in Shanghai, China. Logistic regression analysis and chi(2) test were performed for statistical analysis. RESULTS The response rate was 99.3%. Among all 5677 respondents aged 15-48 years, 48.8% were ECP ever-users. Compared with ever-users, ECP never-users were less likely to have used contraception during the present cycle of conception (P < 0.001). In response to the question on the main reason for non-use of contraception, ECP never-users were less likely to realize the risk of pregnancy and had less contraceptive knowledge (P < 0.001). Among 2773 ECP ever-users, 72.7% did not use ECPs to prevent the current pregnancy, mainly due to lack of awareness of pregnancy risk. Out of 757 women, 437 (57.7%) repeated unprotected sex after taking ECPs during the current pregnant cycle. A pharmacy was the preferred source to access ECPs, for the reason of convenience. CONCLUSIONS Non-use of ECPs was correlated to less knowledge on fertility and a lower rate of contraceptive use among abortion-seeking women. Women of reproductive age should have access to ECPs and receive sufficient information on their use. Health care providers and pharmacists should also be trained in contraceptive counselling, including ECPs.
Language: English
Keywords:
CHINA | RESEARCH REPORT | COHORT ANALYSIS | KAP SURVEYS | CONTRACEPTIVE PREVALENCE SURVEYS | WOMEN IN DEVELOPMENT | ABORTION | EMERGENCY CONTRACEPTION | ATTITUDES | CONTRACEPTIVE PREVALENCE | RISK ASSESSMENT | PERCEPTION | CONDOM USE | PHARMACY DISTRIBUTION | Asia, Eastern | Asia | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Family Planning Surveys | Family Planning | Economic Development | Economic Factors | Fertility Control, Postconception | Contraception | Psychological Factors | Behavior | Contraceptive Usage | Evaluation | Risk Reduction Behavior | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 331002 Notification

13.

Peer Reviewed

Title: Accuracy of information given by Los Angeles County pharmacies about emergency contraceptives to sham patient in need.
Author: Nelson AL; Jaime CM
Source: Contraception. 2009 Mar;79(3):206-10.
Abstract: BACKGROUND: As emergency contraception (EC) becomes increasingly available without prescription, it is important that women in need be provided accurate information about its use. STUDY DESIGN: A telephone survey of all retail pharmacies in Los Angeles County was conducted by women posing as a 23-year-old who wanted to prevent pregnancy after an unprotected act of intercourse. RESULTS: One thousand four hundred sixty unduplicated pharmacies listed in the Yellow Pages 2007 were called between October 2007 and April 2008. Sixty-nine percent had EC available on site; 19% referred the caller elsewhere. The remainder said nothing could be done or hung up. Multiple calls and multiple recitations of the situation were needed in over one third of calls. Isolated incidents of inappropriate comments occurred. CONCLUSION: While most pharmacies provided information about EC that was consistent with labeling, barriers still exist to both accurate information and timely access to that product.
Language: English
Keywords:
CALIFORNIA | RESEARCH REPORT | SURVEYS | WOMEN | PHARMACISTS | PHARMACY DISTRIBUTION | FAMILY PLANNING EDUCATION | EMERGENCY CONTRACEPTION | TELECOMMUNICATIONS | United States of America | North America | Americas | Developed Countries | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Education | Contraception | Family Planning | Broadcast Media | Mass Media | Communication
Document Number: 330057

14.

Peer Reviewed

Title: Does readily available emergency contraception increase women's awareness and use?
Author: Novikova N; Weisberg E; Fraser IS
Source: European Journal of Contraception and Reproductive Health Care. 2009 Feb;14(1):39-45.
Abstract: BACKGROUND: In Australia just over half of all women of reproductive age have experienced an unplanned pregnancy, many of which could have been avoided by use of emergency contraception. A dedicated emergency contraceptive pill (ECP) pack became available on prescription in Australia in 2002, and over the counter in 2004. OBJECTIVES: To determine if availability of a dedicated over the counter ECP pack in Australia increased knowledge and use of emergency contraception (EC). MATERIAL AND METHODS: Women attending three free-standing abortion clinics in Sydney answered an anonymous questionnaire on their knowledge and use of the ECP. Group 1 (208 women) was recruited prior to a dedicated ECP pack being available, group 2 (308) after it was available on prescription, and group 3 (202) after it became available over the counter. RESULTS: Women who had heard about EC were significantly younger (p < 0.005). The mean age of women who had never heard about EC was 29.8 years compared to 26.3 for women who had heard about EC. More women expressed awareness of the ECP after it became available over the counter. Women in group 2 attained a higher educational level than women in the other groups (p < 0.005). There was a significant trend to increased use of the ECP in women of higher educational level (p < 0.005). The use of EC did not increase significantly with improved availability and access. CONCLUSIONS: Among women seeking termination of pregnancy wider availability of the ECP has increased women's awareness of EC but not use.
Language: English
Keywords:
AUSTRALIA | RESEARCH REPORT | KAP SURVEYS | WOMEN | CONTRACEPTIVE USAGE | EMERGENCY CONTRACEPTION | CONTRACEPTIVE AVAILABILITY | PHARMACY DISTRIBUTION | CONTRACEPTIVE DISTRIBUTION | KNOWLEDGE | CONTRACEPTIVE PREVALENCE | AGE FACTORS | EDUCATIONAL STATUS | Developed Countries | Oceania | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Sociocultural Factors | Population Characteristics | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 330346

15.

Peer Reviewed

Title: Comprehension of a prototype emergency contraception package label by female adolescents.
Author: Raymond EG; L'Engle KL; Tolley EE; Ricciotti N; Arnold MV; Park S
Source: Contraception. 2009 Mar;79(3):199-205.
Abstract: BACKGROUND: We evaluated female adolescents' comprehension of a prototype over-the-counter package label for an emergency contraceptive pill product. STUDY DESIGN: Volunteers aged 12-17 years who could read English were recruited at malls and clinics in six United States metropolitan areas. After completing a literacy assessment, subjects examined the prototype package and answered 20 questions that assessed understanding of six key concepts related to appropriate use of the product. RESULTS: The analysis population included 335 subjects, 54 to 59 of each year of age between 12 and 17 years. When asked what the product is used for, 264 respondents (79%) specifically indicated contraception. The six key concepts were each understood by 83-96% of subjects. In all 24 population subgroups examined, each key concept was understood by at least 72% of subjects. CONCLUSION: Female adolescents aged 17 years and younger understand the prototype package label well enough to enable safe and effective use without assistance from a clinician.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | KAP SURVEYS | ADOLESCENTS, FEMALE | EMERGENCY CONTRACEPTION | READING | LANGUAGE | KNOWLEDGE | FAMILY PLANNING EDUCATION | CONTRACEPTIVE MODE OF ACTION | AGE FACTORS | PHARMACY DISTRIBUTION | Developed Countries | North America | Americas | Surveys | Sampling Studies | Studies | Research Methodology | Adolescents | Youth | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Literacy | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Communication | Sociocultural Factors | Education | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration
Document Number: 330058

16.

Peer Reviewed

Title: Barriers to adolescents' getting emergency contraception through pharmacy access in California: differences by language and region.
Author: Sampson O; Navarro SK; Khan A; Hearst N; Raine TR; Gold M; Miller S; de Bocanegra HT
Source: Perspectives On Sexual and Reproductive Health. 2009 Jun;41(2):110-8.
Abstract: CONTEXT: In California, emergency contraception is available without a prescription to females younger than 18 through pharmacy access. Timely access to the method is critical to reduce the rate of unintended pregnancy among adolescents, particularly Latinas. METHODS: In 2005-2006, researchers posing as English- and Spanish-speaking females-who said they either were 15 and had had unprotected intercourse last night or were 18 and had had unprotected sex four days ago-called 115 pharmacy-access pharmacies in California. Each pharmacy received one call using each scenario; a call was considered successful if the caller was told she could come in to obtain the method. Chi-square tests were used to assess differences between subgroups. In-depth interviews with 22 providers and pharmacists were also conducted, and emergent themes were identified. RESULTS: Thirty-six percent of all calls were successful. Spanish speakers were less successful than English speakers (24% vs. 48%), and callers to rural pharmacies were less successful than callers to urban ones (27% vs. 44%). Although rural pharmacies were more likely to offer Spanish-language services, Spanish-speaking callers to these pharmacies were the least successful of all callers (17%). Spanish speakers were also less successful than English speakers when calling urban pharmacies (30% vs. 57%). Interviews suggested that little cooperation existed between pharmacists and clinicians and that dispensing the method at clinics was a favorable option for adolescents. CONCLUSIONS: Adolescents face significant barriers to obtaining emergency contraception, but the expansion of Spanish-language services at pharmacies and greater collaboration between providers and pharmacists could improve access.
Language: English
Keywords:
UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | ADOLESCENTS | HISPANICS | LANGUAGE | EMERGENCY CONTRACEPTION | OBSTACLES | PHARMACY DISTRIBUTION | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Communication | Contraception | Family Planning | Organization and Administration | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Program Evaluation
Document Number: 341529

17.

Peer Reviewed

Title: Scaling up access to antiretroviral drugs in a middle-income country: public sector drug delivery in the Free State, South Africa.
Author: Steyn F; Schneider H; Engelbrecht MC; van Rensburg-Bonthuyzen EJ; Jacobs N; van Rensburg DH
Source: AIDS Care. 2009 Jan;21(1):1-6.
Abstract: This article describes the distribution and management of drugs and supplies in scaling up access to public sector antiretroviral treatment (ART) in a middle-income country. More specifically, a case study of the Free State Province of South Africa is presented focusing on: the mobilisation and training of pharmaceutical staff for ART, processes related to the ordering, distribution and storage of medicines, continuity of ART supplies and the impact of ART delivery on other drugs and supplies. Data were obtained from longitudinal research conducted between April 2004 and July 2006 comprising three surveys of the first 20 health facilities providing ART in the province, key informant interviews and observations made of provincial ART Task Team meetings. The supply of ART in the Province was managed through the existing drug supply system but with special mechanisms to ensure integrity of ART supplies and security of stock within the existing supply system. Initial hiccups in the procurement of antiretroviral (ARV) drugs for South Africa (a national function) caused delays in putting patients on ART, although these supply problems were short-lived. At provincial level, not all pharmacist posts created for the programme were filled, and pharmacists working in the rest of the health system were subsequently trained to take on ART programme functions. Electronic systems were not established at all service sites, which in part contributed to delays in the delivery of drugs and supplies to more peripheral units. Adequate space to safely store ARV drugs remained problematic. The introduction of the ART programme did not create disruptions in the supply of non-ART essential drugs, which in fact improved over the period of observation. It is concluded that despite some process, human resource and infrastructural challenges, the drug management system in the Free State succeeded in incorporating public sector ART within its existing drug distribution network and functions, at least in the initial phase of scale up.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | MIDDLE INCOME POPULATION | DRUGS | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | PHARMACY DISTRIBUTION | ANTIRETROVIRAL DRUGS | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Macroeconomic Factors | Organization and Administration | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Program Evaluation
Document Number: 331215

18.

Peer Reviewed

Title: STI management in Tanzanian private drugstores: practices and roles of drug sellers.
Author: Viberg N; Mujinja P; Kalala W; Kumaranayake L; Vyas S; Tomson G; Lundborg CS
Source: Sexually Transmitted Infections. 2009 Aug;85(4):300-7.
Abstract: OBJECTIVES: To describe the role and possible contribution of private drugstores in sexually transmitted infection (STI) management in rural Tanzania. METHODS: A cross-sectional study that included drug sellers in private drugstores in eight districts of Tanzania. Data collected through interviews with drug sellers and the simulated client method presenting a male and female STI case. "QATI" scores (Questions, Advice, Treatment and drug Information) were developed to describe overall STI management. RESULTS: Although 74% of drug sellers stated that there were no STI-related drugs in the store, medications were dispensed in 78% of male and 63% of female simulated client visits. The clients were dispensed drugs recommended in the Tanzanian guidelines for syndromic management of urethral or vaginal discharge in 80% of male and 90% of female cases. Drug sellers dispensed antibiotics during 76% of male and 35% of female simulated client visits. Dosage regimens were often incorrect and complete syndromic management rarely provided. Most drug sellers agreed that it is within their professional role to give information on STI treatment (89%) and prevention (95%). Drug-use information was almost always provided. Advice was however seldom given and questions occasionally asked. Overall STI management was better for men than for women. CONCLUSIONS: The drug sellers, although aware of the prescription-only status of antibiotics, saw themselves as having a role in STI management and were ready to provide drugs. In this resource-limited setting, drug sellers could provide effective and safe STI management especially to male patients if given appropriate tools to improve practice. The consequences of this for official policy need to be discussed.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PHARMACY DISTRIBUTION | DRUGS | SEXUALLY TRANSMITTED DISEASES | SEXUALLY TRANSMITTED DISEASE PREVENTION | VAGINAL ABNORMALITIES | PRESCRIPTIONS | MANAGEMENT | HEALTH SERVICES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Treatment | Medical Procedures | Medicine | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Diseases
Document Number: 342747

19.

Title: Transporting, storing, and handling malaria rapid diagnostic tests at central and peripheral storage facilities.
Author: World Health Organization [WHO], Regional Office for the Western Pacific; John Snow [JSI]. DELIVER; Foundation for Innovative New Diagnostics [FIND]; Roll Back Malaria Partnership; United States. President's Malaria Initiative
Source: Arlington, Virginia, John Snow [JSI], DELIVER, 2009 Jul. [35] p. (USAID Contract No. GPO-I-03-06-00007-00)
Abstract: The publication is intended for staff at central and peripheral storage facilities that use malaria rapid diagnostic tests (RDTs). It describes the basic principles for management and storage of RDT stock, and it outlines practical solutions for protecting RDTs against high temperatures during storage and transport. It also describes how to manage waste generated from RDT use.
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | MANUAL | TECHNICAL ASSISTANCE | USAID | MALARIA PREVENTION | TREATMENT | ANTIMALARIAL DRUGS | IMPLEMENTATION | LOGISTICS | PHARMACY DISTRIBUTION | SAFETY | QUALITY CONTROL | TESTING | EXAMINATIONS AND DIAGNOSES | PROGRAM ACTIVITIES | Programs | Organization and Administration | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Malaria | Parasitic Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Management | Nonclinical Distribution | Distributional Activities | Public Health | Measurement | Research Methodology
Document Number: 331476

20.

Title: Transporting, storing, and handling malaria rapid diagnostic tests in health clinics.
Author: World Health Organization [WHO]. Regional Office for the Western Pacific; John Snow [JSI]. DELIVER; Foundation for Innovative New Diagnostics [FIND]; Roll Back Malaria Partnership; United States. President's Malaria Initiative
Source: Arlington, Virginia, John Snow [JSI], DELIVER, 2009 Jul. [35] p. (USAID Contract No. GPO-I-03-06-00007-00)
Abstract: The publication is intended for staff at health clinics that use malaria rapid diagnostic tests (RDTs). It describes the basic principles for management and storage of RDT stock, and it outlines practical solutions for protecting RDTs against high temperatures during storage and transport. It also describes how to manage waste generated from RDT use.
Language: English
Keywords:
DEVELOPING COUNTRIES | MANUAL | TECHNICAL ASSISTANCE | HEALTH PERSONNEL | HEALTH FACILITIES | CLINIC ACTIVITIES | MALARIA PREVENTION | TESTING | STORAGE AND WAREHOUSES | LOGISTICS | WASTE MANAGEMENT | PHARMACY DISTRIBUTION | TRANSPORTATION | Programs | Organization and Administration | Delivery of Health Care | Health | Program Activities | Malaria | Parasitic Diseases | Diseases | Measurement | Research Methodology | Management | Environment | Nonclinical Distribution | Distributional Activities | Economic Factors
Document Number: 331477

21.

Peer Reviewed

Title: Do instructions for over-the-counter pre-coital female contraceptives promote "perfect use"?
Author: Zite NB; Wallace LS
Source: Contraception. 2009 Mar;79(3):211-5.
Abstract: BACKGROUND: This study was conducted to estimate the readability and related features of English-language over-the-counter (OTC) pre-coital female contraceptive (PFC) instructions. STUDY DESIGN: We identified and purchased all currently available OTC PFCs (n=8), including Encare (Contraceptive Gel and Insert), F.C. Female Condom, Ortho Options (Conceptrol, Delfen and Gyncol II Jelly), Today Sponge and VCF Vaginal Film. Reading grade level was calculated using the Simple Measure of Gobbledygook. Text point size was measured and total number of graphics was tallied. Graphic dimensions were also measured. We also assessed OTC PFC instructions on four main criteria--derived from the "User-Friendliness Tool (UFT)"--including layout features, graphic characteristics, presence of a clear message and presentation of manageable information. RESULTS: Reading level ranged from 8th to 12th grade (mean+/-SD=10.0+/-1.2). Mean page length was 24.4+/-7.0 cm (9.6+/-2.76 in.), while average page width was 20.3+/-13.8 cm (7.99+/-5.43 in.). Average text point size was 7.9+/-2.3 (range=6-12). Illustrations, predominantly line drawings, were used throughout (range=3-11), and most were similar in size to a matchbox. None of the "How to Use" sections scored high in all criteria on the UFT. CONCLUSIONS: "How to Use" sections of OTC PFC instructions should be revised to be easier to read and more user friendly. Ideally, the gap between "typical" and "perfect" contraceptive efficacy could potentially be narrowed if instructions were developed that the large majority of women could easily understand.
Language: English
Keywords:
TENNESSEE | RESEARCH REPORT | EVALUATION | WOMEN | PHARMACY DISTRIBUTION | USER COMPLIANCE | PROMOTION | LANGUAGE | READING | CONTRACEPTIVE METHODS | FEMALE CONTRACEPTION | FAMILY PLANNING EDUCATION | Developed Countries | United States of America | North America | Americas | Demographic Factors | Population | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Behavior | Marketing | Economic Factors | Communication | Literacy | Educational Status | Socioeconomic Status | Socioeconomic Factors | Contraception | Family Planning | Education
Document Number: 330056

22.

Title: AWARENESS Project. Benin country report, 2002-2007.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Jan. [16] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: Benin became the first African country to introduce the SDM when the Ministry of Health (MOH) and IRH agreed in December 2000 to conduct a pilot introduction study in two urban centers, Cotonou and Parakou. The study determined that strong demand for the method existed; that the SDM could be offered effectively through existing service delivery channels; that there was a high degree of acceptability and continuation of use; and that the SDM could be used correctly and consistently. The government requested IRH?s help to expand delivery of the method nationwide, an effort that began in December 2004. As service sites multiplied, Benin participated in other international, multisite studies, including a long-term (up to two-year) follow up of users and a study to determine the impact of social marketing campaigns on SDM use, particularly comparing pharmacy and clinic-based services. There was no significant difference in correct use between clients who obtained the SDM through clinics and those who obtained it in pharmacies. The government has included the SDM in national reproductive health norms, policies, and training protocols and materials. The AWARENESS Project, in collaboration with local partners, trained more than 600 providers countrywide, recording more than 12,000 SDM acceptors between 2004 and 2007. The SDM is currently offered in more than 150 public, community, and commercial sites in all 12 departments of the country. An evaluation of the integration process after three years showed that the SDM is well integrated into the health system, and was offered in all visited clinics, where 57% of providers had been trained on the SDM. The Benin program serves as a demonstration site for neighboring francophone countries. (excerpt)
Language: English
Keywords:
BENIN | TECHNICAL REPORT | FERTILITY AWARENESS | PILOT PROJECTS | INTEGRATED PROGRAMS | NONGOVERNMENTAL ORGANIZATIONS | FAITH-BASED ORGANIZATION | CLINICAL DISTRIBUTION | PHARMACY DISTRIBUTION | COMMUNITY-BASED DISTRIBUTION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Family Planning, Behavioral Methods | Family Planning | Studies | Research Methodology | Programs | Organization and Administration | Organizations | Political Factors | Sociocultural Factors | Distributional Activities | Program Activities | Nonclinical Distribution
Document Number: 327616

23.

Title: Social marketing final report: three country overview.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Mar. [40] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: While unmet need is growing in sub-Saharan Africa, where contraceptive prevalence is lowest, unmet need remains even in countries where contraceptive prevalence is high, such as in Latin America. Due to rapid growth in the population and increase in the numbers of couples interested in planning and spacing births, reproductive health programs in developing countries face a major challenge: to provide a greater variety of products and services to a rapidly increasing number of users. This challenge must be met in the context of stagnant or decreasing donor funding for contraception. Thus, efforts to meet this unmet need must involve cost-effectively expanding options and access to couples. Social marketing concepts have been successfully applied to increase access and use of many modern contraceptives. The present study was conducted to research the potential of socially-marketing the Standard Days Method® (SDM) in three countries: Ecuador, Benin and the Democratic Republic of the Congo (DRC). The impact of mass media campaigns on knowledge, sales and distribution of the SDM, quality of information provided by pharmacists and providers, and correct use by pharmacy and clinic SDM users was assessed. The aim of the study was to answer the following research questions: What is the impact of a mass media campaign on knowledge, attitudes, sales and free distribution of the SDM?; Can pharmacists and health providers provide high quality information about the SDM?; How do characteristics of women who purchase the SDM from pharmacies compare with those obtain it at a lower or no cost from a clinic?; Can women who purchase the SDM from a pharmacy use the method correctly? (excerpt)
Language: English
Keywords:
AFRICA, SUB SAHARAN | LATIN AMERICA | EVALUATION REPORT | CROSS-CULTURAL COMPARISONS | KAP SURVEYS | WOMEN IN DEVELOPMENT | SOCIAL MARKETING | FERTILITY AWARENESS | COST EFFECTIVENESS | MASS MEDIA | FAMILY PLANNING EDUCATION | PHARMACY DISTRIBUTION | CLINICAL DISTRIBUTION | CONTRACEPTIVE EFFECTIVENESS | Africa | Developing Countries | Americas | Evaluation | Comparative Studies | Studies | Research Methodology | Surveys | Sampling Studies | Economic Development | Economic Factors | Marketing | Family Planning | Evaluation Indexes | Quantitative Evaluation | Communication | Education | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraception
Document Number: 327650

24.
Title: Private pharmacies in an integrated approach to HIV/AIDS services [letter]
Author: Carapinha JL
Source: SAHARA J. 2008 Dec;5(4):206-9.
Abstract: The South African National AIDS Council emphasises that success in tackling HIV/AIDS depends on leadership at every level of society, as well as mobilisation and co-operation in all sectors including government, health care workers and civil society (SANAC, 2006). This may be an acknowledgement that South Africa's response to HIV/AIDS has been inadequate to effectively control the epidemic. It points to insufficient dialogue between the government and the private sector, and among health care workers in general. In particular, there has been inadequate attention given to the importance of private pharmacies in an integrated approach to HIV/AIDS services. In 2006, Member States of the United Nations (which include South Africa) completed a political declaration on HIV/AIDS. In it the commitment was made that efforts would continue to scale-up nationally driven, sustainable and comprehensive responses to achieve broad multisectoral coverage of HIV/ AIDS services (UNAIDS, 2006). The Brazzaville Commitment concluded by African states also calls for innovative ways to mobilise resources for AIDS. These processes depend on building an integrated approach, with the involvement of HIVpositive people, civil society and the private sector. There is therefore a need to investigate the role of private pharmacies in the delivery of HIV/AIDS services. This paper explores this need with the aim of building an integrated approach to meet the challenge of providing HIV and AIDS prevention, care and treatment services. (excerpt)
Language: English
Keywords:
SOUTH AFRICA | SUMMARY REPORT | PERSONS LIVING WITH HIV/AIDS | PHARMACY DISTRIBUTION | PRIVATE SECTOR | HIV PREVENTION | AIDS PREVENTION | HEALTH SERVICES | DELIVERY OF HEALTH CARE | ANTIRETROVIRAL THERAPY | NEEDS ASSESSMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | HIV Infections | Viral Diseases | Diseases | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Macroeconomic Factors | Economic Factors | AIDS | Health | HIV | Evaluation
Document Number: 331151

25.

Peer Reviewed

Title: Ethical, religious and factual beliefs about the supply of emergency hormonal contraception by UK community pharmacists.
Author: Cooper RJ; Bissell P; Wingfield J
Source: Journal of Family Planning and Reproductive Health Care. 2008;34(1):47-50.
Abstract: Community pharmacists' role in the sale and supply of emergency hormonal contraception (EHC) represents an opportunity to increase EHC availability and utilise pharmacists' expertise but little is known about pharmacists' attendant ethical concerns. Semi-structured qualitative interviews were undertaken with 23 UK pharmacists to explore their views and ethical concerns about EHC. Dispensing EHC was ethically acceptable for almost all pharmacists but beliefs about selling EHC revealed three categories: pharmacists who sold EHC, respected women's autonomy and peers' conscientious objection but feared the consequences of limited EHC availability; contingently selling pharmacists who believed doctors should be first choice for EHC supply but who occasionally supplied and were influenced by women's ages, affluence and genuineness; non-selling pharmacists who believed EHC was abortion and who found selling EHC distressing and ethically problematic. Terminological/factual misunderstandings about EHC werecommon and discussing ethical issues was difficult for most pharmacists. Religion informed non-selling pharmacists' ethical decisions but other pharmacists prioritised professional responsibilities over their religion. Pharmacists' ethical views on EHC and the influence of religion varied and, together with some pharmacists' reliance upon non-clinical factors, led to a potentially variable supply, which may threaten the prompt availability of EHC. Misunderstandings about EHC perpetuated lay beliefs and potentially threatened correct advice. The influence of subordination and non-selling pharmacists' dispensing EHC may also lead to variable supply and confusion amongst women. Training is needed to address both factual/terminological misunderstandings about EHC and to develop pharmacists' ethical understanding and responsibility. (author's)
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | CLIENTS | PHARMACISTS | ETHICS | EMERGENCY CONTRACEPTION | PHARMACY DISTRIBUTION | RELIGION | BELIEFS | Developed Countries | Europe, Western | Europe | Program Activities | Programs | Organization and Administration | Health Personnel | Delivery of Health Care | Health | Sociocultural Factors | Contraception | Family Planning | Nonclinical Distribution | Distributional Activities | Culture
Document Number: 323392

26.

27.

Title: Pharmacist conscience clauses and access to oral contraceptives.
Author: Flynn DP
Source: Journal of Medical Ethics. 2008 Jul;34(7):517-20.
Abstract: The introduction of conscience clauses after the 1973 US Supreme Court decision in Roe v. Wade allowed physicians and nurses to opt out of medical procedures, particularly abortions, to which they were morally opposed. In recent years pharmacists have requested the same consideration with regard to dispensing some medicines. This paper examines the pharmacists' role and their professional and moral obligations to patients in the light of recent refusals by pharmacists to dispense oral contraceptives. A review of John Rawls's concepts of the "original position" and the "veil of ignorance", along with consideration of the concept of compartmentalisation, are used to assess pharmacists' requests and the moral and legal rights of patients to have their prescriptive needs met.
Language: English
Keywords:
UNITED STATES OF AMERICA | SUMMARY REPORT | LEGISLATION | LAWS AND STATUTES | PHARMACISTS | PHARMACY DISTRIBUTION | ORAL CONTRACEPTIVES | ETHICS | Developed Countries | North America | Americas | Political Factors | Sociocultural Factors | Health Personnel | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraceptive Methods | Contraception | Family Planning
Document Number: 328832

28.

Title: Emergency contraception: A reasonable personal choice or a destructive societal influence?
Author: Greene MF
Source: Clinical Pharmacology and Therapeutics. 2008;83(1):17-19.
Abstract: A 2003 petition to the US Food and Drug Administration by the manufacturer to move levonorgestrel emergency contraception from prescription status to over-the-counter sale embroiled the Agency in politics and remains controversial in some circles. This essay addresses the current remaining main points of contoversy about the medication and the Agency's decision. On 16 December 2003, the US Food and Drug Administration (FDA) convened a joint session of both the Nonprescription Drugs Advisory Committee and the Advisory Committee for Reproductive Health Drugs to consider an application to move levonorgestrel emergency contraception (Plan B), which had been approved for prescription use in 1999, from prescription to nonprescription (over-the-counter, OTC) status. The meeting was much like many other FDA Advisory Committee meetings, with one major difference. More than 30 groups and individuals requested time to address the committees during the public comment portion of the meeting. FDA staff acknowledged that this was an unprecedented degree of public interest, and each speaker was limited to 3 minutes. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | EMERGENCY CONTRACEPTION | VOTING | PHARMACY DISTRIBUTION | ABORTION RATE | PREGNANCY | PREVENTION AND CONTROL | SAFETY | SEX BEHAVIOR | PROGRAM ACCESSIBILITY | Developed Countries | North America | Americas | Contraception | Family Planning | Political Factors | Sociocultural Factors | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Fertility Control, Postconception | Reproduction | Diseases | Public Health | Health | Behavior | Program Evaluation
Document Number: 323626 Notification

29.

30.