A Nationwide Mystery Caller Evaluation of Oral Emergency Contraception Practices from German Community Pharmacies: An Observational Study Protocol

Abstract

To prevent unwanted pregnancies, oral emergency contraception (EC) with the active ingredients levonorgestrel (LNG) and ulipristal acetate (UPA) is recommended by the guidelines of the German Federal Chamber of Pharmacists (BAK). In this respect, community pharmacies (CPs) in Germany have a major responsibility for information gathering, selecting the appropriate medicine, availability and pricing, among other things. Therefore, it would be appropriate to conduct a study with the aim of investigating information gathering, a possible recommendation as well as availability and pricing for oral EC in German CPs. A representative nationwide observational study based on the simulated patient methodology (SPM) in the form of covert mystery calls will be conducted in a random sample of German CPs stratified according to the 16 federal states. Each selected CP will be randomly called once successfully by one of six both female and male trained mystery callers (MCs). The MCs will simulate a product-based scenario using the request for oral EC. For quality assurance of the data collection, a second observer accompanying the MC is planned. After all mystery calls have been made, each CP will receive written, pharmacy-specific performance feedback. The only national SPM study on oral EC to date has identified deficits in the provision of self-medication consultations with the help of visits in the CPs studied. International studies suggest that UPA in particular is not always available. Significant price differences could be found analogous to another German study for a different indication.

Oral emergency contraception practices of community pharmacies: a mystery caller study in the capital of Germany, Berlin

“…However, counseling on the phone can save the person a possibly avoidable trip to the CP and enable a targeted recommendation (possibly a visit to the doctor). In addition, the term “personal” counseling used in the BAK guidelines may leave room for interpretation and may also be interpreted by CPs to the effect that counseling by phone should not or need not be provided [ 107 ]. A clarifying modification of the guidelines by the BAK may therefore be useful.…”

Development and Pilot Testing of a Dispensing Protocol on Emergency Contraceptive Pills for Community Pharmacists in Belgium

“…On top of that, it still remains unknown to what extent the application of the protocol will succeed in the standardization of ECP conversations and lead to better 'outcomes' in terms of counseling quality (e.g., appropriate decisions and correct and complete advice) and patient satisfaction with reproductive health pharmacy services. Such assessments are needed in the future [25,26], especially as previous research in Australia has shown that although the use of a written ECP checklist improved the quantity and consistency of patient assessment, it did not result in a higher frequency of appropriate decisions [27]. Ultimately, there is no evidence on the knowledge of Belgian pharmacists on EC nor on the knowledge and counseling preferences of the Belgian public regarding this topic.…”