[Emergency contraception: user's profile in primary care emergency services]

A study to assess the knowledge and awareness among young doctors about emergency contraception

Background:

Emergency contraception (EC) is the contraception on demand which can prevent millions of unintended pregnancies. The knowledge and awareness of young doctors towards EC who may be the first contact physician of the society has not been well studied. This study aims to assess the knowledge and awareness of young doctors in a teaching institute in northeast India.

Methodology:

This study was carried out among 200 young doctors and included 100 interns and 100 postgraduate trainees (PGT) and senior resident doctors (SRD) from January 2020 to March 2020 to compare their knowledge and awareness about EC. A predesigned self-administered 22 items questionnaire was used to collect data.

Observation:

In our study, majority of the doctors in both groups were aware of levonorgestrel 1.5 mg tablet as EC (93% and 95%) and more interns than PG SRD were aware of its easy availability (86%, 35%, P value < 0.0001), government supply (77%, 30%, P value < 0.0001), and that copper intrauterine contraceptive device (IUCD) can be used as EC up to 120 h (89%, 60%, P value < 0.0001). Most doctors were unaware of ulipristal acetate. Most PGT SRDs believe that EC promotes irresponsible behavior, sexually transmitted diseases, and promiscuity but most intern did not agree to it (P value < 0.0001 for each). More than 65% doctors in both groups were aware of the mechanism of action of EC. PGT SRD were more aware of the effectiveness of EC (62%, 80%, P value 0.0078). More interns were aware that EC affects the next period (53%, 25%, P value < 0.0001).

Conclusion:

Interns were more aware about contraception than PGT and SRD, especially about government supply of EC, about IUCD, and behavioral aspect like promoting irresponsible behavior, sexually transmitted disease, and promiscuity.

Characterization of the Use of Emergency Contraception from Sentinel Pharmacies in a Region of Southern Europe

Numerous studies have been published suggesting that emergency contraception (EC) is used repeatedly, but a lack of information regarding the profile of users makes it difficult to evaluate actual consumer habits. The aim of this study was to obtain information regarding the profile of users who obtain EC and other factors that might play a role, and to provide criteria to evaluate and improve the strategies of current contraceptive programs. This was an observational one-year study based on surveillance data on the provision of EC to women of reproductive age in 60 community pharmacies in Catalonia, Spain. In total, 941 notifications of dispensation of EC in Catalonia were received. A total of 44.2% of users said it was not the first time that they had taken the medication (repeat user). The percentage of users who used condoms was lower in repeat users compared to first-time users (56.7% vs. 64.4%, p < 0.05). A total of 25.7% of users stated that they did not use any barrier contraceptive method. The use of natural methods in repeat users was 53.8% in the subgroup who requested the medication after 48 h, significantly higher than in users who obtained the medication within the first 24 h (p < 0.05). A high percentage of repeat users with risky sexual behaviors were detected, suggesting that new measures must be implemented to provide information for this method, together with educational and preventive strategies.

Prevalence of emergency contraceptive pill use among Spanish adolescent girls and their family and psychological profiles

BACKGROUND

Adolescent girls' family context and psychological characteristics play important roles in their sexual behavior, including the use of the emergency contraceptive pill (ECP). This study aims to (1) determine the prevalence of ECP use among girls who have had sexual intercourse and (2) comparatively analyze their family and psychological profiles according to whether they have used ECPs.

METHODS

The sample of 1735 Spanish girls aged 15 to 18 came from a representative sample of the 2014 edition of the Health Behaviour in School-aged Children (HBSC) study. Of this sample, 398 girls had sexual intercourse and reported their ECP use. Data collection for the HBSC study was performed through an online questionnaire to which adolescents responded anonymously in school. Data analyses were descriptive and bivariate and were performed with the statistical program IBM SPSS Statistics 23.

RESULTS

The results demonstrated that 30.65% of girls who had sexual intercourse used ECPs. Noticeable differences in paternal knowledge and communication with the father were observed between girls who used the ECP at least once and those who did not use it. In contrast, differences between girls who used the ECP once and those who used it twice or more were pronounced with regard to parental knowledge, communication with parents, maternal affection, life satisfaction, sense of coherence and depression.

CONCLUSIONS

This work demonstrates a high prevalence of ECP use and a more positive family and psychological profile for girls who used ECP once compared with those who used it twice or more.

The Prescription of the Morning-After Pill in a Berlin Emergency Department Over a Four-Year Period - User Profiles and Reasons for Use

Questions: There are no current health care studies from Germany regarding the "morning-after pill". This paper will use routine data to analyse details regarding the users' profiles, reasons for using it and the utilisation of hospital outpatient facilities. Patient Collective and Methods: Retrospective analysis of all triage sheets in the emergency department of the Virchow Hospital Campus/Charité University Hospital, Berlin, over a four-year period from 2007 to 2010 that were coded with the ICD diagnosis Z30 (= contraception advice) and statistical processing of the associated administrative data. Results: 860 triage sheets were included in the analysis. The emergency department is used most frequently for the prescription of the "morning-after pill" at the weekend. The average age of the users was 25.1 years. The most common reason cited for needing emergency contraception was unprotected sexual intercourse, with the second-most common being "condom failure". Around half of the women attended the department within 12 hours of having unprotected sex. Less than 2 % (n = 14) of all women decided against a prescription of emergency contraceptive after counselling. Conclusions: The user profile and reasons for using emergency oral contraception correlate largely with the information contained in international literature. Although the "morning-after pill" is probably prescribed mainly in general practices in Germany, and despite the availability of new drugs with a permitted post-exposure interval of up to 120 hours after unprotected sex, there appears to still be a high demand for counselling and prescriptions of the "morning-after pill" in the context of the emergency department.

[Emergency contraception: evaluation of women's understanding of it, a requisite for the effectiveness of the treatment]

OBJECTIVE

To evaluate how much women who attend primary care consultations understand about the correct use of emergency ("morning after") contraception (EC), their information requirements and their views about free EC prescription.

DESIGN

Cross-sectional study, using a questionnaire.

SETTING

Les Corts Primary Care Centre, Barcelona, Spain.

PARTICIPANTS

A total of 130 women aged 15 to 45 years old who attended primary care consultations in May and June, 2005, were included. One-hundred and twenty-four of them (95.4%) agreed to the questionnaire.

MAIN MEASUREMENTS

We tested knowledge of EC, and we drew up a questionnaire to evaluate understanding. This had 4 multiple-choice questions, as well as socio-demographic data, contraception background, how they preferred to obtain EC, and their information requirements.

RESULTS

We found a lack of knowledge about several aspects of EC use: in particular, 33% of the women thought that EC eliminated completely the risk of pregnancy. We only found differences for better knowledge of EC in women who had used it before (3.03; 95% CI, 2.29-3.77) versus those who had never used it (2.47; 95% CI, 1.54-3.4; P=.028. Free prescription of EC in health centres was approved of by 75.8%, while 83.1% said they needed more information. Their preferred method to obtain this information was by leaflet.

CONCLUSIONS

Women who attend primary health care clinics have a need for information on EC. Their lack of knowledge could limit the effectiveness of treatment. A brief explanation and handing out a leaflet could solve this problem.