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Improving access to quality contraceptive counselling in community pharmacy: examining the knowledge, attitudes and practices of community pharmacists in Australia
  1. Pip Louise Maria Buckingham1,
  2. Safeera Hussainy1,2,
  3. Judith Soon3,
  4. Wendy V Norman4,5,
  5. Deborah Bateson6,7,
  6. Danielle Mazza1
  1. 1Monash University Department of General Practice, Notting Hill, Victoria, Australia
  2. 2Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  3. 3The University of British Columbia Faculty of Pharmaceutical Sciences, Vancouver, British Columbia, Canada
  4. 4Dept of Family Practice, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
  5. 5Public Health, Environments and Society, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
  6. 6Faculty of Medicine and Health, The University of Sydney, The Daffodil Centre, Sydney, New South Wales, Australia
  7. 7Family Planning New South Wales, Ashfield, New South Wales, Australia
  1. Correspondence to Mx Pip Louise Maria Buckingham, Monash University Department of General Practice, Notting Hill, VIC 3168, Australia; pip.buckingham{at}monash.edu

Abstract

Background Across most of Australia, the role of community pharmacists in contraceptive care has been unchanged since 2004. To understand their current scope of practice and potential for practice advancements, we examined community pharmacists’ contraceptive knowledge and their attitudes, practices and perceived barriers to and benefits of contraceptive counselling provision.

Methods A nationwide postal survey was conducted between September and December 2020. We contacted a state/territory-stratified sample of 2149 community pharmacies and limited eligibility to one pharmacist per pharmacy. Summary statistics of respondent characteristics and parametric (χ2, linear regression) and non-parametric (Mann-Whitney, logistic regression) tests were computed for the outcomes: practices, knowledge (reported and tested), confidence, attitudes, barriers and benefits.

Results Eligible responses were received from 366 pharmacies (19%). Pharmacists’ median age was 34. Most (85% of) pharmacists agreed that contraceptive counselling fits within their current professional activities and emphasised benefits to their patients, including improved access to contraceptive decision support (80%), as being key motivators of counselling. A lack of payment mechanisms (66%), training opportunities (55%) and technical assistance tools (54%) were the most important barriers. Self-rated knowledge and confidence were highest for combined oral contraceptive pills and lowest for the copper intrauterine device (IUD). When tested, pharmacists were very knowledgeable about method, dosage, frequencies and costs, and relatively less knowledgeable about side-effects and IUD suitability for adolescents.

Conclusions Community pharmacists provide contraceptive information and counselling but lack the necessary resources and support to be able to consistently provide quality, person-centred care. Remuneration mechanisms, training opportunities and pharmacy-specific professional resources need to be explored.

  • Health Services Research
  • Counseling
  • Contraceptive Agents, Female
  • Pharmaceutical Services
  • Patient Education as Topic
  • Contraceptive Devices, Female

Data availability statement

Data are available upon reasonable request. De-identified data available for secondary analyses upon request.

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Data availability statement

Data are available upon reasonable request. De-identified data available for secondary analyses upon request.

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Footnotes

  • Twitter @PipBuckingham, @wvnorman, @DrDebBateson

  • Contributors PB: conceptualisation (lead); methodology (lead); writing – original draft (lead). SH, JS, WVN, DB, DM: conceptualisation (supporting); methodology (supporting); writing – review and editing (equal); guarantor (DM).

  • Funding This work is supported by the National Health and Medical Research Council (NHMRC) grant number 1143492 (Centre for Research Excellence in Sexual and Reproductive Health for Women in Primary Care (SPHERE)), and the Australian Government Research Training Program. WVN holds the Canadian Institutes for Health Research-Public Health Agency of Canada Applied Public Health Chair in Family Planning Research CPP-329455-107837 2014-2024).

  • Competing interests DM has received research funding, travel grants and honorarium from Bayer. The other authors have no conflict of interest to declare.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.