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Greater pharmacy role could slash Scottish teenage pregnancies

Practice Offering oral contraceptives, implants and specialist sexual health clinics in pharmacies could build on the EHC PGD to help further slash teenage pregnancy rates in Scotland, pharmacy leaders have argued.

Pharmacists could help tackle teenage pregnancy rates in Scotland by supplying contraceptives more widely than they do already, pharmacy leaders have argued.

Offering oral contraceptives, implants and specialist sexual health clinics in pharmacies could further cut teenage pregnancy rates in the country, the NPA said in response to a Scottish government inquiry into the issue.

And the Royal Pharmaceutical Society (RPS) called for pharmacists to provide "at least an interim supply of regular oral contraception" to repeat emergency hormonal contraception (EHC) users, in its response to the consultation, which closed last week (February 7).

The NPA suggested that training to prescribe oral contraceptives, fit implants and give contraceptive injections in pharmacies could boost access to sexual health services

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Providing EHC in pharmacies through the patient group direction (PGD) service had helped to cut the number of pregnancies in women aged under 20 in Scotland by 22 per cent between 2008 and 2011, the RPS argued.

And RPS director for Scotland Alex MacKinnon said community pharmacy could still do more to tackle teenage pregnancies. "It is vital that women receive EHC when required, but it is of equal importance that repeat users are followed up and supported to find suitable alternatives for their long-term family planning requirements," he said.

"Provision of at least an interim supply of regular oral contraception would be a natural addition to the service and minimise the need for repeat supplies of EHC," Mr MacKinnon suggested.

He also called for pharmacy to "expand and improve" existing EHC provision and consider adding new forms to the PGD service that could be taken up to 120 hours after intercourse. C+D reported last month that pharmacies in Bradford and Airedale were offering the five-day emergency contraceptive ellaOne without a prescription, as part of their NHS EHC service.

The NPA echoed the recommendations, suggesting that training to prescribe oral contraceptives, fit implants and give contraceptive injections in pharmacies could boost access to sexual health services.

"Community pharmacies are instantly recognisable to clients, very accessible, open longer hours than other NHS sites, typically require no appointments and have confidential, suitably equipped consultation rooms," it said. The NPA also called for a way of measuring pharmacy's contribution to teenage pregnancy rates.

Douglas Forsyth, pharmacy manager at Baird's Pharmacy, Aberdeen, backed the calls for pharmacy to play a greater contraceptive supply role. "I think pharmacies would be the perfect place for people to be started on contraceptives," he told C+D. "You sometimes see people coming back two, three or four times in a year for EHC, so it would be fantastic if you could try to help them by getting a regular contraceptive."

And Numark said pharmacies should step up their offering in areas where there was low provision of sexual health services. "Health commissioners should be more proactive in engaging services to reduce teenage pregnancies," said Colin Miller, Numark's pharmacy development manager in Scotland.

Pregnancies among the under-20 age group in Scotland fell from 52.9 per 1,000 women to 50.2 between 2009 and 2010. But the rate among under 16s remained static, and women in this group were five times more likely to become pregnant if they lived in deprived areas.

MPs' calls in December for pharmacies to provide emergency intrauterine device (IUD) fittings as part of a national strategy in England to tackle unplanned pregnancy were met with mixed reaction from C+D readers. Many said that they would need more training in order to do it.

How else can pharmacy tackle teenage pregnancy?

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valerie sillito, Community pharmacist

I run a contraceptive clinic in a community pharmacy at the same time that the local Family Planning clinic is open so that I have instant access to help/information if I need it. I provide COC/POP to any patient over 16 and the FP concentrates on any younger clients who may need more specialised help. It has proved highly popular as I am more accessible on a Thursday evening "late night shopping" slot and a lot of patients remark on how much more convenient our service is than trying to get an appointment at the gp. I totally agree that it is a good idea to at least discuss contraception with any EHC patient and my clinic allows me to offer a viable service. However I did receive training from the local FP service beforehand and found that very helpful in giving me confidence to deal with these patients. I see absolutely no reason why all pharmacists/pharmacies could not provide this service. Provided you have a private room/more than one trained pharmacist offering the depo injection could also be a possibility.

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