Article Text

Download PDFPDF
Impact of an early medical abortion at home pack of medicines in Scotland
  1. Nathan Burley1,
  2. Kirsten Cameron2,
  3. Audrey Brown2,
  4. Christine Black2
    1. 1 Pharmacy Public Health, NHS Greater Glasgow and Clyde, Glasgow, UK
    2. 2 Sandyford Initiative, NHS Greater Glasgow and Clyde, Glasgow, UK
    1. Correspondence to Mr Nathan Burley; nathan.burley{at}ggc.scot.nhs.uk

    Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Why was change required?

    Abortion care involves the provision of up to seven medicines: abortifacients,1 analgesia, an antiemetic, contraception2 and occasionally an antibiotic. This is a large volume of pharmaceuticals supplied and is similar to the amount of medicines supplied after a heart attack. More medicines per intervention carries greater complexity and associated problems.3

    Legislation changes during the COVID-19 pandemic allows for abortion medicines to be taken at home in Scotland for up to 12 weeks’ gestation.4 Previously mifepristone needed to be consumed at an approved clinical site. Significant time was spent by clinical staff assembling medicines boxes for postage and collection. Full packs of antiemetic medicines and analgesia were given locally, more than required for the procedure, leading to accumulation and wastage in patient homes. Provision of analgesia and antiemetics across Scotland vary leading to unnecessary variation.

    To reduce staff time spent on medicines-related activities, minimise wastage and harmonise medicines usage, an over-labelling unit was commissioned to produce the early medical abortion at home (EMAH) pack. Such units possess licenses that allow for ‘packing down’ of medicines to create pre-labelled packs that do not require any further manipulation to meet relevant regulatory requirements before supply to patients, saving time at clinic level. The pack would be rolled out in Glasgow and made available to all health systems in the country for medical abortion up to 10 weeks.4

    EMAH packs are prescribed by doctors as per Abortion Act 1967 and Human Fertilisation and Embryology Act 1990 requirements.5 6 The EMAH pack is pre-bagged and labelled …

    View Full Text

    Footnotes

    • X @NathanBurley4

    • Contributors NB drew the work together in this format for submission and is the main author. He was the liaison between the Sandyford Clinic and NHS Tayside Pharmaceutical Specials Service (PSS) who produced the early medical abortion at home (EMAH) pack. KC, AB and CB were part of the clinical group that planned and steered the EMAH pack creation and came up with the initial concept for the work.

    • 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.

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