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A 5-year evaluation of the emergency contraception enhanced community pharmacy service provided in Wales
  1. Efi Mantzourani1,
  2. Karen Hodson1,
  3. Andrew Evans2,
  4. Sarah Alzetani1,
  5. Rebecca Hayward1,
  6. Rhian Deslandes1,
  7. Mary Louise Hughes1,
  8. Gareth Holyfield3,
  9. Cheryl Way4
  1. 1 School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
  2. 2 Llywodraeth Cymru, Cardiff, UK
  3. 3 Public Health Wales, Cardiff, UK
  4. 4 National Health Service Wales Informatics Service, Cardiff, UK
  1. Correspondence to Dr Efi Mantzourani, School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, South Glamorgan CF10 3AT, UK; MantzouraniE1{at}


Background Access to emergency contraception (EC) has been a core component of attempts to address high teenage pregnancy rates in Wales. A national service was commissioned in 2011, allowing supply of EC free of charge from community pharmacies (CPs). This study investigated 5 years of the EC service, to describe its use and investigate changes in the pattern of use over time.

Methods Secondary analyses of data from all National Health Service funded CP EC consultations in Wales between 1 August 2012 and 31 July 2017 (n=181 359). Data comprised standardised clinical and demographic information, in the form of predefined service user responses, submitted for reimbursement by CPs.

Results Overall service provision remained relatively consistent over the study period, with women aged between 13 and 59 years accessing the service. An association was observed between the time since unprotected sexual intercourse and the day on which the service was accessed (Χ2(18)=16 292.327, p<0.001). Almost half (47.9%) of requests were because no contraception had been used, with a strong and positive association for teenagers and women aged 40+ years. A statistically significant and increasing percentage of consultations were accompanied by further sexual health advice (r=0.7, p<0.01).

Conclusions Access to EC through CPs is contributing to reducing teenage conceptions and termination rates. However, action is needed to increase contraception use in all age groups. Reduced availability of CP services on Sundays is a barrier to timely EC access. Findings support an expanded role for community pharmacists in provision of regular contraception.

  • emergency contraception
  • community pharmacy service
  • secondary analysis
  • oral contraception
  • sex education
  • service delivery

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  • Contributors EM, KH, AE and CW contributed to the planning of the work reported. AE contributed to obtaining the data. SA and RH completed the initial analysis and interpretation of the data. EM and KH supervised the initial analysis and completed further analysis and interpretation of the data. EM led the drafting of the initial report. EM, KH, AE, RD, MLH, GH and CW contributed to discussion and drafting of subsequent drafts of the report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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