Category Archives: Pharmacist’s role

It is important that women understand that ellaOne® is not a regular form of contraception.1 EC is not 100% effective and it is not as effective as a regular contraceptive method.

It is critical women understand that ellaOne® will not protect them from pregnancy if they have unprotected sex again after taking ellaOne®. They should use a reliable barrier contraceptive method until their next menstrual period, even if they are taking a regular contraceptive pill.2 EC is not contraindicated in women using oral contraceptives but they should read the leaflet inside the pack to find out about continuing use of oral contraceptives in the month that they use ellaOne®.2 The EU package leaflet is also available online .

 

References
1.ellaOne® European Union Summary of Product Characteristics.
2.ellaOne® European Union Patient Information Leaflet.

Fast access to ellaOne® after UPSI is important. When women come to your pharmacy seeking emergency contraception it is essential that your team know how to respond, so that women get the help they need to avoid unintended pregnancy.

Portrait of Smiling Woman Pharmacist in Pharmacy

Your team should know :

  •  Your pharmacy offers EC
  •  Whether women requesting EC must be referred to a pharmacist or if it can be dispensed by any team member
  •  Your aim is to offer women EC with as little fuss as possible

 

In training sessions you could develop more examples or role-play the scenarios to build the team’s confidence so they can deal with requests for emergency contraception smoothly.
You can encourage your team to make the process of obtaining ellaOne® as fuss-free as possible. They should recognise that this may be an emotional time for the woman. In a large European Union survey, 50% of women said they found seeking EC embarrassing,1 so a welcoming, professional approach is appropriate. Other women may ask for EC in a way that may make you or your team members feel uncomfortable, maybe by providing too many intimate details or having a loud or brazen manner.  Exploring ways to deal with this can also form part of a training role-play.
References
1.HRA Data on File. Harris Interactive 2013.

Sexuality and sexual behaviour are sensitive topics. They are part of our most private lives. When a woman asks for emergency contraception, she is disclosing that she had sexual intercourse and that the couple did not use, or had a problem with, their contraception.

When it comes to emergency contraception, some pharmacists can be confronted with his or her own prejudices. It is important to remember that couples and individuals have a right to decide freely and responsibly the timing and number of their children.1 Women who seek emergency contraception are behaving responsibly by taking steps to avoid unintended pregnancy. They need a warm approach. Treating all women in this way is always good practice, especially as some women may have been coerced to have sex (but not necessarily be disclosing this fact to you).

Unprotected sex or contraceptive failure can happen to anyone, for a number of different reasons. 

HRA-Paharmacie-Situations-368 (1280x853)

 

It can happen to anyone
Over a woman’s fertile life it would be most unusual if there were not occasional lapses in contraceptive cover
Love (and sex) are unpredictable, but dealing with unexpected events sensibly is the responsible thing to do
Women may stop their regular contraception for many reasons, including because they have no established partner
Human behaviour is complex and sometimes unpredictable
If she’s having sex she needs reliable contraception – including emergency contraception (provided within national guidelines where they exist)

Step 1: Listen A woman comes to your pharmacy and asks for the morning-after -illshe asks you for the MAP (1280x853)
Step 2: Reassure
  • If you had unprotected sex in the last 5 days and you wish to avoid becoming pregnant, you are right to ask for the emergency contraceptive pill1,2

HRA-Paharmacie-Situations-497 (1280x853)

Step 3: Encourage immediate action You should take emergency contraception as soon as possible1,2 because it is most effective when used as soon as possible after unprotected sex3HRA-Paharmacie-Situations-443 (1280x853)
Step 4: Advise about sex after EC intake A rapid return to fertility is likely following treatment with an emergency contraceptive pill.A barrier method of contraception must be used until your next period – even if you are continuing with an oral method of contraception (OC).1,2The emergency contraceptive pill is for occasional use only: it should not be used to replace a regular contraceptive method.1,2 Oral emergency contraception is not 100% effective and its efficacy is lower than a regular contraceptive method.1,2 Please see your doctor to discuss the various regular contraceptive options.You should continue or start regular contraception to prevent pregnancy in the future.1,2 Emergency contraceptive pill does not protect from STIs.2,4Only condoms protect against STIs.
Step 5: Advise what to do if the woman is sick If vomiting occurs within 3 hours of emergency contraception intake you should take another tablet as soon as possible.1,2
Step 6: Advise about the next menstrual period After taking oral emergency contraception, menstrual periods can sometimes occur earlier or later than expected by a few days.1,2If your period is more than five days late or pregnancy is suspected for any other reason (symptoms of pregnancy, abnormal bleeding at the expected date of menstrual periods) or in case of doubt, you should do a pregnancy test or visit your doctor to make sure you are not pregnant.1,2HRA-Paharmacie-Situations-368 - Copie (800x533)

 

Pharmacists’ role when providing ellaOne®

Discussing emergency contraception can be distressing for women and it can also be uncomfortable for pharmacists.

You can help by:

  • Being matter-of-fact
  • Making their experience as easy as possible
  • Offering them a more private place to talk if possible
  • Using customer’s language e.g. Morning-after pill, Day-after pill
  • Having a warm and positive approach

You can use the good practice at the counter guide as a framework for your conversation.

Customer satisfaction and comfort in discussing ECPs with a pharmacist can be very high.3

References
1.ellaOne® European Union Summary of Product Characteristics.
2.World Health Organization. (In association with the International Consortium for Emergency Contraception, International Federation of Gynacology and Obstetrics, International Planned Parenthood Federation, Department of Reproductive Health and Research). Fact sheet on the safety of levonorgestrel-alone emergency contraceptive pills. Available at: http://whqlibdoc.who.int/hq/2010/WHO_RHR_HRP_10.06_eng.pdf AccessedOctober2013.
3. Taylor B. Journal of Family Planning and Reproductive Health Care 2003: 29(2): 7.