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Attention Pharmacists and Registered Pharmacy Technicians - Emergency Contraception: Then and Now.
Much has changed since certified pharmacists were first able to independently prescribe emergency contraception pills (ECPs) in British Columbia in 2000. Patients finally had rapid access to ECPs, promoted to reduce the risk of pregnancy after unprotected intercourse by 89% (i.e. levonorgestrel) and 75% (i.e. Yuzpe regimen). Initial optimism was that with increased awareness and access to ECPs, unintended pregnancies and abortions would decline.
Since that time, ECP access has increased, yet BC abortion rates have remained fairly stable. Recent research indicates that EC effectiveness is lower than initially proposed (e.g. levonorgestrel ~50% effective; Yuzpe regimen ~ 40% effective).
Two more effective emergency contraception (EC) options are available. The copper intrauterine device (Cu-IUD) can reduce the risk of pregnancy by 99.9%, and be inserted up to 7 days after unprotected intercourse by a trained healthcare provider (e.g. physician or nurse practitioner). The Cu-IUD device is hormone-free, and once inserted, can provide ongoing reversible contraception for up to 12 years depending on device model. To facilitate urgent insertion of the Cu-IUD, an innovative online EC-IUD RAPID ACCESS NETWORK identifies trained healthcare providers able to insert Cu-IUDs for EC within 7 days.
An increasing number of pharmacists are working in close collaboration with certified physicians and nurse practitioners in their communities, and have been able to enhance the timely use of Cu-IUDs for EC. Since Cu-IUDs are designated as a “device” by Health Canada, pharmacists are able to dispense the product directly to the woman without a prescription. Check the patient’s insurance coverage criteria should a prescription be required from a prescriber.
The newest oral ECP is ulipristal acetate (EllaR), which is more effective than levonorgestrel (e.g. ~60% effective), and is the oral EC agent of choice in many jurisdications. Ulipristal acetate is now available through drug wholesalers and available on prescription by a prescriber.
A new interactive, mobile-friendly, and accredited online module, Emergency Contraception Update, is available FREE for pharmacists and pharmacy technicians to enhance clinical skill development. The engaging program includes interactive video case studies to help pharmacists counsel patients at risk of unplanned or unwanted pregnancy, and pharmacy technicians to refer patients to pharmacists when needed.
Judith A. Soon, BSc(Pharm), RPh, ACPR, PhD, FCSHP
Judith Soon is an Assistant Professor in the Faculty of Pharmaceutical Sciences at the University of British Columbia, and Associate Member of the UBC School of Population and Public Health and UBC Department of Family Practice. Dr. Soon is a reproductive health researcher and educator leading an extensive research and education program into the public health impact of pharmacist provision of emergency contraception. She has coordinated the online Emergency Contraception Update program for healthcare professionals and facilitated the development of an online rapid referral network for women in British Columbia to facilitate urgent insertion of copper IUDs for emergency contraception.
- UBC, Professional Development, Guest Post
