Background

Community pharmacy contraception services are thought to improve access, with the potential to reduce the persistent sexual and reproductive health inequities observed globally.

Objectives

We aimed to identify the range of pharmacy-based initiatives addressing unintended pregnancy in the primary literature and examine their feasibility, acceptability and effectiveness.

Method

Using the Joanna Briggs Institute Methodology for Scoping Reviews, we searched seven bibliographic databases using combinations of keywords and subject headings for related to contraception and community pharmacy. Studies of any design undertaken in high income countries for reproductive-aged women were eligible provided they evaluated intervention or legislation after the implementation of these initiatives. Included articles were critically appraised and findings summarised narratively.

Results

We identified 49 articles, 80% of which involved pharmacist supply of emergency contraception (EC), 14% of regular contraception methods, and 6% involved adjuncts of EC dispensing: counselling (2%) and bridging initiatives to link clients with regular contraception (4%). EC initiatives were perceived as feasible and were facilitated by interdisciplinary partnerships but there are persistent barriers to the provision of initiatives congruous with the retail pharmacy setting. Furthermore, consumers may be reluctant to receive contraceptive counselling from pharmacists but often value the convenience and anonymity pharmacy services offer. Overall, interventions improved access to contraceptive products but did not consistently reduce inequities, and the health benefits of pharmacy initiatives are either small (EC) or lacking description in the literature (other contraceptive methods and contraceptive counselling).

Conclusions

Pharmacy initiatives may not negate all barriers to access or reduce unintended pregnancy rates, however they are valued by pharmacists and consumers. Evidence gaps including the lack of description of health outcomes of regular contraception provision, contraceptive counselling and the perceived barriers and facilitators of access and provision from end-user perspectives, should be pursued in future research, to establish initiatives’ utility and effectiveness.

中文翻译：

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基于药房的减少意外怀孕的举措：范围审查

背景

社区药房避孕服务被认为可以改善获取途径，并有可能减少全球观察到的持续性和生殖健康不平等现象。

目标

我们旨在确定主要文献中针对意外怀孕的一系列基于药房的举措，并检查其可行性、可接受性和有效性。

方法

使用 Joanna Briggs Institute Methodology for Scoping Reviews，我们使用关键字和主题标题的组合搜索了七个与避孕和社区药学相关的书目数据库。在高收入国家为育龄妇女进行的任何设计研究都符合条件，前提是他们在实施这些举措后评估了干预措施或立法。对纳入的文章进行了批判性评价，并以叙述方式总结了调查结果。

结果

我们确定了 49 篇文章，其中 80% 涉及药剂师提供紧急避孕药 (EC)，14% 涉及常规避孕方法，6% 涉及 EC 配药的辅助：咨询 (2%) 和将客户与常规避孕联系起来的桥梁举措（ 4%）。EC 举措被认为是可行的，并得到跨学科合作伙伴关系的推动，但在提供与零售药房环境一致的举措方面存在持续障碍。此外，消费者可能不愿意接受药剂师的避孕咨询，但往往重视药房提供的便利和匿名服务。总体而言，干预措施改善了避孕产品的获取，但并没有持续减少不平等现象，

结论

药房举措可能无法消除所有障碍或降低意外怀孕率，但它们受到药剂师和消费者的重视。在未来的研究中，应在未来的研究中寻求证据差距，包括缺乏对定期避孕提供、避孕咨询的健康结果的描述，以及从最终用户的角度感知到的障碍和获取和提供的促进因素，以确定举措的效用和有效性。