Family Practice, Vol 15, 449-456, Copyright © 1998 by World Organization of Family Doctors
S Ziebland, A Graham and A McPherson
OBJECTIVES: We aimed to describe GPs' responses to a clinical scenario of a
request for a repeat prescription for hormonal emergency contraception
(EC), their views about over-the-counter availability and beliefs about
absolute contraindications. DESIGN: We conducted semi- structured
tape-recorded telephone interviews with 76 GPs randomly selected from the
medical registers of three health authorities which were chosen for high,
medium and low prescribing rates for EC. RESULTS: There was a wide
variation in the number of times that GPs would be happy to prescribe EC to
the same woman in a year. The content of the consultations appeared patchy.
While 59 (77.6%) of the GPs said that they would discuss future
contraception with the woman, only 16 (21.1%) said they would talk about
possible side effects and 28 (36.3%) would discuss the timing of the next
menstrual period and the possibility of method failure. Fifty-two of the
practices had a family-planning- trained practice nurse, yet only four
(7.7%) had arrangements whereby the nurse could provide EC. Unqualified
enthusiasm for deregulation was rare. Concerns included that women would
lose out on the benefits of the consultation; worries about the safety of
the method; that some women might 'abuse' it by using it frequently; and
that certain characteristics of the pharmacy might make it an unsuitable
setting for provision of EC. CONCLUSIONS: This qualitative telephone survey
revealed concerns about repeated use of EC and caution about the prospects
of deregulation. Respondents were worried that pharmacists might not be
able to address all of the features of the consultation that may be valued,
yet in this sample nor do most GPs. Family-planning- trained practice
nurses are an under-utilized resource and could act as a halfway house
between provision by GPs and deregulation.
ORIGINAL CLINICAL RESEARCH
Concerns and cautions about prescribing and deregulating emergency contraception: a qualitative study of GPs using telephone interviews
University Department of Public Health and Primary Care, Institute of Health Sciences, Oxford, UK.
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