Knowledge, attitudes, and practices toward emergency contraceptive pills among community pharmacists and pharmacy customers: A cross-sectional study in urban Vietnam

OBJECTIVES

This study aimed to investigate Vietnamese community pharmacists and pharmacy customers' knowledge, attitudes, and practices about emergency contraceptive pills (ECPs).

STUDY DESIGN

We recruited 400 pharmacists and 396 customers via a nonprobability convenience sampling technique. We used univariate and multivariate linear regression models to determine factors associated with the knowledge and attitudes toward ECPs among pharmacists and customers. We selected variables in the multivariate models through the Bayesian Model Averaging method using R software (version 4.2.3).

RESULTS

In medicine outlets, levonorgestrel and mifepristone (ECPs) were highly available. The average knowledge scores on ECPs among pharmacists and customers were 9.98 ± 2.00 and 6.24 ± 2.33, respectively. Many pharmacists did not have adequate knowledge of ECPs' mechanism of action, dosage, and contraindications. Customers lacked knowledge about their legislation, effectiveness, and side effects. The attitudes toward ECPs among participants were relatively positive. Reliable information sources about ECPs (such as the package leaflet, courses, and books) played an essential role in increasing ECP knowledge and attitudes (p < 0.001). The availability of ECPs (p < 0.001), being educated (p < 0.01 and 0.01), and daily sales (p < 0.001) were significantly associated with pharmacists' knowledge/attitudes. Age, education level, marital status, and occupation were significantly associated with customers' knowledge. Participants' knowledge of was significantly associated with their attitude toward ECPs (p = 0.02 and p < 0.001, respectively).

CONCLUSIONS

The knowledge of ECPs among pharmacists was relatively good, while that of customers was poor. There is a need to have policies and interventions to enhance the knowledge and attitudes toward ECPs for both pharmacists and customers.

IMPLICATIONS

Community pharmacies are ideal settings to dispense contraceptive methods, especially over-the-counter ECPs. Community pharmacists can help ensure the availability of ECPs in medicine outlets, increase women's access to ECPs, and counsel customers on up-to-date and comprehensive knowledge about these medications, thereby guaranteeing rational ECP use.

Emergency contraceptive knowledge and associated factors among abortion experienced reproductive age women in Ethiopia: a multilevel analysis using EDHS 2016 data

BACKGROUND

Emergency contraceptives (EC) are used to avoid unintended pregnancy, hence avoiding its incidence and its effects. In Ethiopia, emergency contraception is commonly accessible, especially in the big cities. However, there is virtually little understanding of or awareness of EC and Ethiopia has a high abortion rate. Therefore this study was aimed to assess the magnitude and associated factors for emergency contraceptive knowledge in Ethiopia.

METHODS

The study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A total weighted sample of 1236 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of emergency contraceptive knowledge. Statistical significance was determined using Adjusted Odds Ratio (AOR) with 95% confidence interval.

RESULTS

Overall magnitude of emergency contraceptive knowledge was observed to be 17.19% (95% CI: 15.18, 19.40) with intra-class correlation (ICC) 57% and median odds ratio (MOR) 6.4 in the null model. Women's age 25-34 (AOR = 2.6; 95% CI: 1.2, 5.5), and 35-49 (AOR = 1.5; 95% CI: 1.06, 3.3), secondary and above educational level (AOR = 3.41; 95% CI: 2.19, 4.88), media exposure (AOR = 2.97; 95% CI: 1.56, 5.64), Being in metropolitan region (AOR = 2.68; 95% CI: 1.46, 4.74), and women being in urban area (AOR = 3.19; 95% CI: 1.20, 5.23) were associated with emergency contraceptive knowledge.

CONCLUSION

Emergency contraceptive knowledge in this study was low. Women age, educational level, media exposure, residency, and region were significantly associated with emergency contraceptive knowledge. Therefore, to enhance understanding and use of ECs in the current Ethiopian setting, it is imperative to ensure exposure to EC information, particularly in rural regions.

Emergency contraceptive use of Metronidazole among University female students in Dodoma region of Tanzania: a descriptive cross-sectional study

BACKGROUND

Metronidazole is known for its therapeutic effect as antibacterial and anti-parasitic. However, its toxicity on the reproductive system remains unclear. Metronidazole use in rodents is associates with toxic effects on the reproductive system, including hormonal alterations, reduced number of fertile cells and reduced sites for implantation, size of the placental disc area, constituent elements of the labyrinth, and spongiotrophoblast layers. Its use at a therapeutic dose among humans has been associated with an increased risk of spontaneous abortion. The effects on the reproductive system in humans may result in misconceptions about contraceptive effects hence sexually active individuals like students who, for any reason, fail to access safe contraceptive services use any possible methods to protect them from conception. This study aims to investigate the unofficial (un-prescribed) use of Metronidazole as an emergency contraceptive and some of its associated factors.

METHODS

This quantitative cross-sectional study involved 470 participants where stratified random sampling technique was used to obtain the sample from three educational institutions in the Dodoma Municipal, Dodoma region. Collected data were analyzed using SPSS version 25, descriptive statistical analysis was done to determine frequencies, percentages, and association, p < 0.05 was used to determine statistical significance. Further analysis using Multivariate binary logistic regression was done to determine the nature of the association between the study variables.

RESULTS

The finding shows that 169(62.4%) use Metronidazole as an emergency contraceptive. Notably, 345(73.4%) stated that they had ever heard someone use Metronidazole for contraception, especially their peers. Furthermore, an increase in the year of study was significantly associated with reduced use of Metronidazole as an emergency contraceptive (B = [-0.45], p = [0.02]). Furthermore, an increase in age, studying in non-medical college/university, the experience of using contraceptive methods, and hearing someone ever used Metronidazole was found to be positively associated with its use as an emergency contraceptive, although not statistically significant.

CONCLUSION

Metronidazole was found to be used as an emergency contraceptive in high doses, different factors associated with its use, and reasons influencing its use. Further research may be done to explore the toxicological effect of high doses of Metronidazole as a contraception and compare the efficiency of Metronidazole over other emergency contraceptives.

Determinant of emergency contraceptive practice among female university students in Ethiopia: systematic review and meta-analysis

Introduction

Despite Ethiopia’s government’s commitment to alleviating unwanted pregnancy and unsafe abortion by increasing holistic reproductive health service accessibility, the rate of unwanted pregnancy among female students in the universities is distressing and becoming a multisectoral concern. Therefore, this systematic review aimed to assess the prevalence and determinant of emergency contraceptive practice among female university students in Ethiopia.

Result

The overall pooled prevalence of emergency contraceptive practice among female university students in Ethiopia was 34.5% [95% CI [20.8, 48.2%]. The pooled odds ratio showed that positive association between practice of emergency contraceptives with age of the students [OR, 0.19; 95% CI: 0.04, 0.98, P = 0.05] Previous contraceptive methods use [OR, 0.22; 95% CI: 0.12, 0.40, P = 0.0001], Marital status [OR, 0.09; 95% CI: 0.02, 0.40, P < 0.002] and knowledge [OR, 0.12; 95% CI: 0.04, 0.37, P < 0.0003].

Conclusion

The practice of emergency contraceptives among university female students was 34.5% and explained by knowledge, age, previous use of contraceptive methods and marital status.

Emergency contraceptive knowledge, utilization and associated factors among secondary school students in Wolkite town, southern Ethiopia, cross sectional study

Background

Ethiopia is one of the sub-Saharan African countries with high maternal mortality and morbidity, unsafe abortion and adolescent births. Despite different policy measures taken by the government to improve sexual and reproductive health among adolescents their success is not well studied in Ethiopia. The objective of this study is to explore emergency contraceptive related knowledge, practice and its determinants among secondary school students in southern Ethiopia.

Methods

An institution-based cross-sectional study was conducted in selected high schools of Wolkite town, Southern Ethiopia from December to November 2019. Single population proportion formula was used to calculate sample size. A total of 327 female students participated in the study with a total response rate of 97%. Data were collected using a self-administered, structured questionnaire and cleaned, entered and analyzed using Statistical package for social science software version 21.

Result

153 (54.8%) of the study participants had good knowledge about emergency contraceptives and only (40.5%) of sexually active participates used emergency contraceptives after unprotected sex. Type of admission and grade level of participants and discussion of reproductive health related issues with parents were significantly associated with good knowledge of Emergency contraceptive. Having partner and grade level of students were among the significant determinants of emergency contraceptive utilization.

Conclusion

The study showed an acceptable level of emergency contraceptive knowledge but only less than half of sexually active respondents used emergency contraceptives. To prevent unintended pregnancy among secondary school students sexual and reproductive health education should be given to students starting from their enrollment. Furthermore, parents should be encouraged to freely discuss sexual and reproductive health matters with their children.

The intrauterine device as emergency contraception: how much do young women know?

BACKGROUND

Unprotected intercourse is common, especially among teens and young women. Access to intrauterine device (IUD) as emergency contraception (EC) can help interested patients more effectively prevent unintended pregnancy and can also offer ongoing contraception. This study evaluated young women's awareness of IUD as EC and interest in case of need.

STUDY DESIGN

We conducted a secondary analysis of data from young women aged 18-25 years, not desiring pregnancy within 12 months, and receiving contraceptive counseling within a cluster-randomized trial in 40 US Planned Parenthood health centers in 2011-2013 (n=1500). Heath centers were randomized to receive enhanced training on contraceptive counseling and IUD placement, or to provide standard care. The intervention did not focus specifically on IUD as EC. We assessed awareness of IUD as EC, desire to learn more about EC and most trusted source of information of EC among women in both intervention and control groups completing baseline and 3- or 6-month follow-up questionnaires (n=1138).

RESULTS

At follow-up, very few young women overall (7.5%) visiting health centers had heard of IUD as EC. However, if they needed EC, most (68%) reported that they would want to learn about IUDs in addition to EC pills, especially those who would be very unhappy to become pregnant (adjusted odds ratio [aOR], 1.3; 95% confidence interval, 1.0-1.6, p<.05). Most (91%) reported a doctor or nurse as their most trusted source of EC information, over Internet (6%) or friends (2%), highlighting providers' essential role.

CONCLUSION

Most young women at risk of unintended pregnancy are not aware of IUD as EC and look to their providers for trusted information. Contraceptive education should explicitly address IUD as EC.

IMPLICATIONS

Few young women know that the IUD can be used for EC or about its effectiveness. However, if they needed EC, most reported that they would want to learn about IUDs in addition to EC pills, especially those very unhappy to become pregnant. Contraceptive education should explicitly address IUD as EC.

The power of the patient question: A secret shopper study

OBJECTIVES

To examine the effect of one standardized patient question on the length, number and type of new topics pharmacists addressed. To explore how community pharmacists counsel secret shoppers on two types of over-the-counter (OTC) medications-ibuprofen (IB) and emergency contraceptives (EC).

METHODS

25 pharmacists from 7 independent, midwestern community pharmacies consented to have secret shoppers purchase an OTC medication and to have their consultations audio-recorded. Following standardized scenarios, 5 secret shoppers audio-recorded 73 encounters. At the end of 36 encounters secret shoppers asked one standard question, "What else should I know before taking this product?" Role Theory informed the study design with apriori hypotheses that topics assessed, topics discussed, and consultation length would vary by the OTC medication (IB or EC) and whether secret shoppers asked a question. Audio-recording coding had high inter-rater reliability (kappa=0.94).

RESULTS

Length of encounter was significantly associated with patients asking the question (p<0.05), but not type of OTC medication. On average 1.22 new topics were discussed with a patient question. New topics included information about safe and efficacious use of the OTC's.

CONCLUSION

Results highlight the importance of encouraging patients to ask pharmacists their questions about OTC products for safe use and thorough consultations.

Knowledge, attitude and practice of emergency contraception among graduating female students of jimma university, southwest ethiopia

BACKGROUND

Emergency contraception refers to methods that women can use to prevent pregnancy after unprotected sexual intercourse, method failure or incorrect use. Unwanted pregnancy followed by unsafe abortion can be avoided by using different contraceptive methods including emergency contraceptives. The objective of this study was to assess the knowledge, attitude and practice of emergency contraception among graduating female students of Jimma University main campus.

METHODS

A cross-sectional study was conducted in Jimma University main campus in 2009. The calculated sample size was allocated to each faculty proportions to size of female students. Then within the faculty the sample unit was selected by using simple random sampling technique. Data was collected using self administered questionnaire and analyzed using SPSS for widow version 16.0.

RESULTS

A total of 389 (96.5%) volunteered graduating female students participated in the study. One hundred sixty three (41.9%) were ever heard of Emergency Contraceptive, only 11(6.8%) used the method. The common sources of information were friends 60 (36.5%), radio 37 (22.8%) and television 20 (12.3%). One hundred sixteen (71.2%) agreed to use Emergency Contraceptive when they practice unintended sexual intercourse.

CONCLUSION

Awareness and use of emergency contraception among graduating female students of Jimma University was low. There is a need to educate adolescents about emergency contraceptives, with emphasis on available methods and correct timing of use.