Cross-sectional Research on Japanese Pharmacists' Awareness of Emergency Contraceptives Using Web Survey / 日本プライマリ・ケア連合学会誌

Introduction: In Japan, online medical care for emergency contraceptives (ECP) was approved in 2019, but only trained pharmacists can fill the prescriptions. Pharmacists are required to confirm necessary information and provide medication counseling and psychological support for women. The government mentions the need for future consideration regarding over-the-counter (OTC) drugs. Therefore, this study aimed to clarify the awareness and efforts of pharmacists regarding ECP through a questionnaire survey.Methods: A web-based questionnaire survey was conducted involving 229 randomly selected pharmacists.Results: The self-assessment of pharmacists' ECP-related knowledge was low, especially their lack of knowledge of the mechanism of action (31.9%). It was also suggested that 60.3% of pharmacists were concerned about women's psychological support. No pharmacist requested an ECP prescription through online medical care, but 46.9% wanted to attend a training session in the future and request a prescription. A total of 44.5% of pharmacists were against OTC conversion of ECP.Conclusion: At this point, many pharmacists are worried about ECP-related knowledge and the psychological support of patients. Common patient-handling procedure manuals and explanatory documents are required to appropriately respond to patients'. Additionally, improving the knowledge and preparation of pharmacists for OTC drugs was considered necessary.

Determinants of emergency contraceptive utilization among female tertiary students in the middle belt of Ghana, West Africa

Introduction: Emergency Contraceptives (ECs) are after-coital contraceptive methods used before implantation. These give females in the sexually active age group the opportunity to prevent unplanned pregnancies after refusing to patronize a contraceptive before unprotected sexual intercourse or when a regular contraceptive fails and or when raped. Higher education students fall under the sexually active age category and form a higher risk group for unplanned pregnancy because of inadequate utilization of ECs. The aim of this study was to identify the determinants of ECs utilization among female tertiary students in the Middle Belt of Ghana, West Africa. Methods: institutional-based descriptive cross-sectional study design was used with quantitative method in collecting the data from 28th March 2022 to 18th April 2022. A total of 535 female tertiary students were recruited using simple random proportionate sampling technique. Data were collected using structured questionnaires and entered into Stata version 15 and analyzed descriptively and inferentially using Chi-squared test. A conventional p<0.05 was considered statistically significant. Results: out of the 535 respondents that were interviewed, majority (426 (79.6%) were aware of ECs. However, only 44 (9.4%) had good knowledge of ECs utilization. All respondents who were affiliated to traditional religion had poor knowledge. About half of 279 (52.1%) indicated they ever utilized ECs and 200 (71.7%) of these said the efficacy of ECs was between 75-99%. Regarding barriers to ECs utilization, 333 (20.5%) indicated ECs cause infertility and 330 (20.4%) mentioned the fear of being seen by others. All Chi-square test of associations of demographic characteristics and knowledge on ECs were not statistically significant (p≥0.05). Conclusion: the study reported that ECs utilization among female tertiary students was quite low despite majority being aware of them. Most of them had poor knowledge on ECs utilization, even though majority had not experienced unplanned pregnancies. Further reproductive health and family planning education and promotion initiatives directed on the utilizations of ECs, their efficacies and typology are needed, especially among future health professionals who will later educate other young adults.

Dinâmica contraceptiva antes e após o uso da anticoncepção de emergência: descontinuidades contraceptivas e bridging / Contraceptive dynamics before and after the use of emergency contraception: contraceptive discontinuities and bridging / Dinámica anticonceptiva antes y después del uso de anticonceptivos de emergencia: discontinuidades anticonceptivas y bridging

Os objetivos do estudo foram estimar a ocorrência de bridging, ou seja, o quanto as mulheres que não usavam métodos contraceptivos, começaram a utilizá-los no mês subsequente ao uso da anticoncepção de emergência; e estimar as taxas de descontinuidade contraceptiva antes e após o uso da anticoncepção de emergência. A coleta dos dados ocorreu por meio de um histórico retrospectivo diário sobre o uso de métodos nos 30 dias antes e após o uso da anticoncepção de emergência, com 2.051 usuárias de unidades básicas de saúde de São Paulo, Aracaju (Sergipe) e Cuiabá (Mato Grosso), Brasil. Resultados do estudo revelaram que, em média, as mulheres iniciaram o uso do método 7,6 dias (DP = 2,4) após o uso da anticoncepção de emergência e a descontinuidade ocorreu 17,1 dias (DP = 7,0) após o uso da mesma. A maioria das mulheres utilizou um método de forma contínua 30 dias antes (44,4%) e 30 dias após (65,7%) a anticoncepção de emergência. Foi identificado que apenas 8,1% das mulheres que não utilizavam método antes da anticoncepção de emergência, usaram após o seu uso (bridging). Ter 35 ou mais anos de idade (OR = 1,8; IC95%: 1,4-2,6) associou-se com o uso de métodos contraceptivos após a utilização da anticoncepção de emergência, entre mulheres que não usavam métodos. Residir em Aracaju (OR = 0,7; IC95%: 0,4-0,9), associou-se negativamente. Concluiu-se que uma ínfima parte das mulheres que não utilizava método anticoncepcional algum antes da anticoncepção de emergência, iniciaram o uso após o uso desta (bridging).

The study's objectives were to estimate the occurrence of bridging, that is, the degree to which women that had not been using contraceptive methods began to use them in the month following the use of emergency contraception, and to estimate the rates of contraceptive discontinuity before and after the use of emergency contraception. Data collection occurred through a retrospective daily history on the use of methods in the 30 days before and after the use of emergency contraception, with 2,051 users of primary health care units in São Paulo, Aracaju (Sergipe), and Cuiabá (Mato Grosso), Brazil. The study's results showed that on average, women began their use of the method 7.6 days (SD = 2.4) after the use of emergency contraception, and that discontinuity occurred 17.1 days (SD = 7.0) after its use. Most of the women used the method continuously 30 days before (44.4%) and 30 days after (65.7%) emergency contraception. Only 8.1% of the women who had not been using the method before emergency contraception used it afterwards (bridging). Age 35 years or older (OR = 1.8; 95%CI: 1.4-2.6) was associated with the use of contraceptive methods after the use of emergency contraception among women who had not been using methods before. Residence in Aracaju (OR = 0.7; 95%CI: 0.4-0.9) showed an inverse association. In conclusion, a negligible portion of women who had not been using contraceptive methods before emergency contraception began using them afterwards (bridging).

Los objetivos del estudio fueron estimar la ocurrencia de bridging, es decir, durante cuánto tiempo las mujeres, que no usaban métodos contraceptivos, comenzaron a utilizarlos en el mes subsiguiente al uso de la anticoncepción de emergencia; así como estimar las tasas de discontinuidad anticonceptiva antes y después del uso de métodos anticonceptivos de emergencia. La recogida de datos se produjo mediante un historial retrospectivo diario sobre el uso de métodos durante 30 días antes y después del uso de anticonceptivos de emergencia, con 2.051 pacientes de unidades básicas de salud de São Paulo, Aracaju (Sergipe) y Cuiabá (Mato Grosso), Brasil. Los resultados del estudio revelaron que, de media, las mujeres comenzaron el uso del método 7,6 días (DE = 2,4) tras el uso de la anticoncepción de emergencia, y la discontinuidad se produjo 17,1 días (DE = 7,0) tras la utilización de la misma. La mayoría de las mujeres utilizaron un método de forma continua 30 días antes (44,4%) y 30 días después (65,7%) de la anticoncepción de emergencia. Se identificó que solamente un 8,1% de las mujeres que no utilizaban un método antes de la anticoncepción de emergencia, tras su uso, comenzaron con el (bridging). Tener 35 o más años de edad (OR = 1,8; IC95%: 1,4-2,6) se asoció con el uso de métodos anticonceptivos, tras la utilización de la anticoncepción de emergencia, entre mujeres que no usaban métodos. Residir en Aracaju (OR = 0,7; IC95%: 0,4-0,9) se asoció negativamente. Se concluyó que una ínfima parte de las mujeres que no utilizaban método antes de la anticoncepción de emergencia comenzaron con su uso tras la misma (bridging).

Unmet Need of Emergency Contraceptives: The Curious Scenario of Female Undergraduates in the Niger Delta.

Background: The high morbidity and mortality among young women from unsafe abortions resulting from unwanted pregnancy and teenage pregnancy are mostly as a result of low contraceptive usage especially emergency contraceptives (EC). This is often due to restricted availability, limited knowledge, worries about side effects and future fertility, underestimation of pregnancy risk, high cost, religious and cultural barriers. Objectives: This study aimed to assess the knowledge, use and unmet need of emergency contraceptives among female undergraduates of the Niger Delta University. Methods: This is a cross sectional study conducted in July 2013 among 450 female students who were randomly selected using the multi-stage sampling technique. Data were collected with the aid of a pre-tested, structured self-administered questionnaire. Epi-Info 3.5.3 was used for data entry and analysis. Results: More than half (60.2%) of the students were aware of emergency contraception, friends/relatives being the commonest source of information for 42.5% of the students. Levonorgestrel only EC was the most commonly known EC (57.1%). About a third (30.3%) believed that EC can be used for termination of pregnancy and chemists/pharmacies were reported by 63.9% as the most common place of procurement of ECs. Nearly half of the students (45.6%) were sexually active; only 4.8% of the sexually experienced students had ever used EC; and 17.2% had had unsafe abortion. Reported barriers to the use of EC include high cost, unmarried status, nonavailability and being young. Conclusion: There is low level of use of EC among the female undergraduates of the Niger Delta University, mostly as a result of misconception, poverty, negative attitude of care providers and restricted availability. We recommend the introduction of the study of family planning methods into the school curriculum and there should be unrestricted access to EC on the campus.

Anticoncepción de emergencia / Emergency contraception

La anticoncepción de emergencia es un término utilizado para describir un método hormonal que prevenga el embarazo no deseado después de haber tenido relaciones sexuales sin protección. Básicamente existen dos tipos: el uso de dispositivo intrauterino liberador de cobre (DIU) y el uso de medicamentos, compuestos de estrógenos y progesterona o de progesterona sola. Tiene 3 mecanismos de acción: 1) alteración del moco cervical; 2) acción anovulatoria; 3) impidiendo la implantación del óvulo fecundado. La dosis necesaria para la anticoncepción es de 75mg de levonorgestrel (LNG), tomadas en 2 dosis, la primera máximo 72 horas después de tener relaciones sexuales sin protección y la segunda a las 12 horas de la primera. También se utiliza, aunque no está recomendado su uso, el mifepristone (RU-486) un antiprogestágeno el cual se usa a dosis muy variables que pueden ir de los 2 a los 600mg.

Emergency contraception is a term used to describe a hormonal method to prevent unwanted pregnancy after having sexual intercourse without protection. There are basically two types: Copper intrauterine contraceptive device and medication such as estrogen and progesterone or just progesterone. It has three mechanisms of action: 1) cervical mucus alteration; 2) anovulatory action; 3) to prevent implantation of fertilized egg. Necessary dose for contraception is levonorgestrel (LNG), 75 mg in two doses, the first maximum 72 hours after having sexual intercourse without protection and the second 12 hours later after the first dose. Also mifepristone (RU-486) in variable doses 2- 600 mg is used though it’s not recommended.