Abstract
Objective The aim of this study is to assess Turkish pharmacists’ counseling practices and attitudes regarding emergency contraception pills (ECPs). Setting This cross-sectional observational study was conducted via a web-based survey in Turkey. Methods Pharmacists registered at a professional web site (n = 822) were invited to fill in the study questionnaire; 624 questionnaires were completed and further analyzed. Pharmacists who agreed to participate in the study completed the questionnaire which was structured to elicit their demography, professional experience, counseling practices and attitudes regarding ECP. Attitudes were measured by 18 items under four domains: “reproductive health; information and availability; risk behavior and regulatory restrictions”. The answer choices consisted of five items as: “totally agree, agree, neither agree nor disagree, disagree and totally disagree”. Main outcome Measures The rate of counseling on various aspects of the ECPs and the rate of negative/positive attitudes. Results The aspects most frequently counseled on by the pharmacists were dosage, timeframes, efficacy and pregnancy testing. Less frequently counseled aspects were mechanism of action, methods of contraception and side-effects. In general, the pharmacists displayed positive attitudes towards all domains of the survey; while they were negative to the items suggesting that ECP should be sold only to women and only on prescription. Another interesting finding is that 58 % of the pharmacists agreed with the item suggesting limiting the ECP sales to those over 18 years of age. Conclusions Our results showed that the pharmacists served the clients in need of emergency contraception more frequently than the other health-care providers and in general had favorable attitudes towards ECP. Some aspects of their counseling practices need to be improved. This can be accomplished through continuous education programs that would equip them with the competence to provide counseling on emergency contraception which will in turn help prevent unintended pregnancies and reduce abortion rates.
Similar content being viewed by others
References
Abuabara K, Becker D, Ellertson C, Blanchard K, Schiavon R, Garcia SG. As often as needed: appropriate use of emergency contraceptive pills. Contraception. 2004;69:339–42.
Norris Turner A, Ellertson C. How safe is emergency contraception? Drug Saf. 2002;25:695–706.
Trussell J, Rodríguez G, Ellertson C. Updated estimates of the effectiveness of the Yuzpe regimen of emergency contraception. Contraception. 1999;59:147–51.
Gainer E, Blum J, Toverud EL, Portugal N, Tyden T, Nesheim BI, et al. Bringing emergency contraception over the counter: experiences of nonprescription users in France, Norway, Sweden and Portugal. Contraception. 2003;68:117–24.
Anderson C, Blenkinsopp A. Community pharmacy supply of emergency hormonal contraception: a structured literature review of international evidence. Hum Reprod. 2006;21:272–84.
ECP status and availability chart. Consortium for emergency contraception. Available at: http://www.cecinfo.org. Accessed 30 Jan 2012.
Hacettepe University, Institute of Population Studies, Ministry of Health, Mother and Child Health and Family Planning General Directorate, State Planning Organisation and European Union. Turkish demographic and health survey 2003. Ankara, 2004.
Planning pregnancies before they even happen. World Health Organization, 2005. Available at: http://www.who.int/ whr/2005/chapter3/en/index3.html. Accessed 30 Jan 2012.
Ergor G, Akin A. Abortion in Turkey. In: Akin A, Bertan M, editors. Contraception, abortion and maternal health services in Turkey. Calverton: Ministry of Health of Turkey and Macro International; 1996. p. 91–113.
Akin A, Kocoglu GO, Akin L. Study supports the introduction of early medical abortion in Turkey. Reprod Health Matters. 2005;13:101–9.
Glasier A, Baird D. The effects of self-administering emergency contraception. N Engl J Med. 1998;339:1–4.
Ellertson C, Winikoff B, Armstrong E, Camp S, Senanayake P. Expanding access to emergency contraception in developing countries. Stud Fam Plann. 1995;26:251–63.
Randomised controlled trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception. Task Force on Postovulatory Methods of Fertility Regulation. Lancet. 1998;352:428–33.
Aneblom G, Lundborg CS, Carlsten A, Eurenius K, Tydén T. Emergency contraceptive pills over-the-counter: practices and attitudes of pharmacy and nurse-midwife providers. Patient Educ Couns. 2004;55:129–35.
Eczaci Profili: 1998–2007 Son On Yila bir Bakis. Turk Eczacilari Birligi Arastirma Dizisi. Turkish Pharmacists’ Association. Ankara, 2007.
Mandiracioglu A, Mevsim V, Turgul O. Health personnel perceptions about emergency contraception in primary health-care centers. Eur J Contracept Reprod Health Care. 2003;8:145–9.
Uzuner A, Unalan P, Akman M, Cifcili S, Tuncer I, Coban E, et al. Providers’ knowledge of, attitude to and practice of emergency contraception. Eur J Contracept Reprod Health Care. 2005;10:43–50.
Zeteroglu S, Sahin G, Sahin HA, Bolluk G. Knowledge and attitudes towards emergency contraception of health-care providers in a region with a high birth rate. Eur J Contracept Reprod Health Care. 2004;9:102–6.
Yam EA, Gordon-Strachan G, McIntyre G, Fletcher H, Garcia SG, Becker D, et al. Jamaican and Barbadian health care providers’ knowledge, attitudes and practices regarding emergency contraceptive pills. Int Fam Plan Perspect. 2007;33:160–7.
Blanchard K, Harrison T, Sello M. Pharmacists’ knowledge and perceptions of emergency contraceptive pills in Soweto and the Johannesburg Central Business District, South Africa. Int Fam Plan Perspect. 2005;31:172–8.
Sevil U, Yanikkerem E, Hatipoglu S. A survey of knowledge, attitudes and practices relating to emergency contraception among health workers in Manisa, Turkey. Midwifery. 2006;22:66–77.
Ellertson C, Shochet T, Blanchard K, Trussell J. Emergency contraception: a review of the programmatic and social science literature. Contraception. 2000;61:145–86.
Queddeng K, Chaar B, Williams K. Emergency contraception in Australian community pharmacies: a simulated patient study. Contraception. 2011;83:176–82.
Hussainy SY, Stewart K, Chapman CB, Taft AJ, Amir LH, Hobbs MK, et al. Provision of the emergency contraceptive pill without prescription: attitudes and practices of pharmacists in Australia. Contraception. 2011;83:159–66.
Muia E, Blanchard K, Lukhando M, Olenja J, Liambila W. Evaluation of an emergency contraception introduction project in Kenya. Contraception. 2002;66:255–60.
Szucs M, Szöllosi AP, Bártfai G. Knowledge and attitudes of pharmacists regarding over-the-counter emergency contraception in South-Eastern Hungary. Eur J Contracept Reprod Health Care. 2010;15:336–42.
Fuentes EC, Azize-Vargas Y. Knowledge, attitudes and practices in a group of pharmacists in Puerto Rico regarding emergency contraception. P R Health Sci J. 2007;26:191–7.
Raine TR, Harper CC, Rocca CH, Fischer R, Padian N, Klausner JD, et al. Direct access to emergency contraception through pharmacies and effect on unintended pregnancy and STIs: a randomized controlled trial. JAMA. 2005;293:54–62.
Acknowledgments
We gratefully acknowledge the assistance of Bedreddin Sahbaz (State Social Security Institution) for his helps at various stages of this study.
Funding
This project received grant from Marmara University Scientific Research Projects Committee (file no. SAG-D-270109-0016).
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Apikoglu-Rabus, S., Clark, P.M. & Izzettin, F.V. Turkish pharmacists’ counseling practices and attitudes regarding emergency contraceptive pills. Int J Clin Pharm 34, 579–586 (2012). https://doi.org/10.1007/s11096-012-9647-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-012-9647-x