Podcast
Questions and Answers
What is the maximum time frame in which EllaOne should be taken after unprotected sexual intercourse?
What is the maximum time frame in which EllaOne should be taken after unprotected sexual intercourse?
- 72 hours
- 168 hours
- 120 hours (correct)
- 96 hours
What important principle should pharmacists uphold when consulting with patients requesting emergency hormonal contraception?
What important principle should pharmacists uphold when consulting with patients requesting emergency hormonal contraception?
- Ensure the patient feels at ease and maintain confidentiality (correct)
- Encourage patients to seek parental consent
- Maintain a professional yet judgmental demeanor
- Only confirm the patient's age
Under which condition can young persons under 16 receive treatment without parental consent according to the Fraser Guidance?
Under which condition can young persons under 16 receive treatment without parental consent according to the Fraser Guidance?
- If they are coerced into seeking treatment
- If they have previously consented to treatment
- If they are accompanied by a guardian
- If they can understand the advice given (correct)
At what age does the law in the UK consider a person unable to legally consent to sexual activity?
At what age does the law in the UK consider a person unable to legally consent to sexual activity?
What is the general approach regarding safeguarding issues for patients of all ages according to the provided guidelines?
What is the general approach regarding safeguarding issues for patients of all ages according to the provided guidelines?
What is one of the primary goals in addressing sexual health issues in England according to the framework?
What is one of the primary goals in addressing sexual health issues in England according to the framework?
Which age group showed the highest number and conception rate for five consecutive years as of 2021?
Which age group showed the highest number and conception rate for five consecutive years as of 2021?
Which of the following issues is NOT highlighted as a significant challenge in sexual health in England?
Which of the following issues is NOT highlighted as a significant challenge in sexual health in England?
What record percentage of conceptions led to legal abortion in 2021?
What record percentage of conceptions led to legal abortion in 2021?
Which of the following statements correctly represents a change in conception rates among young women in England since 2011?
Which of the following statements correctly represents a change in conception rates among young women in England since 2011?
What is emphasized as vital in providing sexual health services at pharmacies?
What is emphasized as vital in providing sexual health services at pharmacies?
What is one of the methods promoted to reduce the rate of STIs in England?
What is one of the methods promoted to reduce the rate of STIs in England?
Which of the following best describes the trend regarding unwanted pregnancies according to the framework?
Which of the following best describes the trend regarding unwanted pregnancies according to the framework?
What is the effectiveness percentage of Levonorgestrel when taken within 49-72 hours after unprotected sexual intercourse (UPSI)?
What is the effectiveness percentage of Levonorgestrel when taken within 49-72 hours after unprotected sexual intercourse (UPSI)?
Which of the following is NOT a potential reason for needing emergency hormonal contraception (EHC)?
Which of the following is NOT a potential reason for needing emergency hormonal contraception (EHC)?
How many pharmacies in the UK provide the Emergency Hormonal Contraception (EHC) service?
How many pharmacies in the UK provide the Emergency Hormonal Contraception (EHC) service?
What is the recommended double dose of Levonorgestrel for some patients?
What is the recommended double dose of Levonorgestrel for some patients?
When should emergency hormonal contraception (EHC) be offered to women after childbirth?
When should emergency hormonal contraception (EHC) be offered to women after childbirth?
What is the maximum time frame for using Ulipristal after UPSI to maintain its effectiveness?
What is the maximum time frame for using Ulipristal after UPSI to maintain its effectiveness?
Which of the following is a non-pharmacological form of Emergency Contraception (EC)?
Which of the following is a non-pharmacological form of Emergency Contraception (EC)?
What is the ideal timing for most effective use of emergency hormonal contraception after UPSI?
What is the ideal timing for most effective use of emergency hormonal contraception after UPSI?
Which enzyme-related condition can affect the effectiveness of hormonal contraceptives?
Which enzyme-related condition can affect the effectiveness of hormonal contraceptives?
What is the effectiveness percentage of the Copper IUD when used within 120 hours after UPSI?
What is the effectiveness percentage of the Copper IUD when used within 120 hours after UPSI?
Which of the following is NOT one of the five criteria that must be satisfied regarding a young person receiving contraceptive treatment?
Which of the following is NOT one of the five criteria that must be satisfied regarding a young person receiving contraceptive treatment?
What is the effectiveness of levonorgestrel when taken within 24 hours after unprotected sexual intercourse (UPSI)?
What is the effectiveness of levonorgestrel when taken within 24 hours after unprotected sexual intercourse (UPSI)?
When assessing the menstrual history of a patient seeking emergency hormonal contraception, which factor is NOT relevant?
When assessing the menstrual history of a patient seeking emergency hormonal contraception, which factor is NOT relevant?
What should a healthcare professional consider when a patient presents for emergency hormonal contraception and is over 70kg?
What should a healthcare professional consider when a patient presents for emergency hormonal contraception and is over 70kg?
If a young person cannot be persuaded to inform their parents, which aspect of their situation is being addressed?
If a young person cannot be persuaded to inform their parents, which aspect of their situation is being addressed?
Which of the following scenarios would NOT be a valid reason for a person to seek emergency hormonal contraception?
Which of the following scenarios would NOT be a valid reason for a person to seek emergency hormonal contraception?
What should be determined about the patient's menstrual cycle before supplying emergency hormonal contraception?
What should be determined about the patient's menstrual cycle before supplying emergency hormonal contraception?
When discussing potential pregnancy with a patient, which factor should be assessed?
When discussing potential pregnancy with a patient, which factor should be assessed?
What is the primary age restriction for accessing Levonelle One Step®?
What is the primary age restriction for accessing Levonelle One Step®?
Which of the following statements is true regarding the Fraser Guidance?
Which of the following statements is true regarding the Fraser Guidance?
How does the law in the UK define consent for sexual activity in individuals under 16?
How does the law in the UK define consent for sexual activity in individuals under 16?
What is a critical consideration during consultations for emergency hormonal contraception?
What is a critical consideration during consultations for emergency hormonal contraception?
What is the maximum time frame for using Ulipristal after UPSI to ensure its effectiveness?
What is the maximum time frame for using Ulipristal after UPSI to ensure its effectiveness?
What is a key issue that the framework for sexual health improvement in England aims to address?
What is a key issue that the framework for sexual health improvement in England aims to address?
Which strategy is emphasized to reduce unwanted pregnancies in England?
Which strategy is emphasized to reduce unwanted pregnancies in England?
What was the reported trend for the conception rate among women under 18 years in recent years?
What was the reported trend for the conception rate among women under 18 years in recent years?
What percentage of conceptions leading to abortion reached a record high in 2021?
What percentage of conceptions leading to abortion reached a record high in 2021?
What role do pharmacies play in health protection concerning Chlamydia infections?
What role do pharmacies play in health protection concerning Chlamydia infections?
What is one of the priorities for HIV prevention and treatment in high-risk groups?
What is one of the priorities for HIV prevention and treatment in high-risk groups?
Which aspect is crucial for pharmacies when providing sexual health services?
Which aspect is crucial for pharmacies when providing sexual health services?
What is the goal related to STIs as outlined in the framework for sexual health improvement in England?
What is the goal related to STIs as outlined in the framework for sexual health improvement in England?
Which criterion indicates that a young person is likely to suffer if not provided with contraceptive treatment?
Which criterion indicates that a young person is likely to suffer if not provided with contraceptive treatment?
What is a crucial question to ask regarding a patient's history before providing emergency hormonal contraception?
What is a crucial question to ask regarding a patient's history before providing emergency hormonal contraception?
What specific factor impacts the effectiveness of Levonorgestrel for patients weighing over 70kg?
What specific factor impacts the effectiveness of Levonorgestrel for patients weighing over 70kg?
Which of the following should be determined about a patient's menstrual cycle when assessing the need for emergency hormonal contraception?
Which of the following should be determined about a patient's menstrual cycle when assessing the need for emergency hormonal contraception?
What does the Fraser Guidance allow regarding young persons under 16 seeking contraceptive treatment?
What does the Fraser Guidance allow regarding young persons under 16 seeking contraceptive treatment?
In the context of emergency hormonal contraception, what does UPSI stand for?
In the context of emergency hormonal contraception, what does UPSI stand for?
What aspect of a young person's situation is specifically addressed if they are resistant to informing their parents?
What aspect of a young person's situation is specifically addressed if they are resistant to informing their parents?
What is the effectiveness percentage of Levonorgestrel when taken within 24 hours after unprotected sexual intercourse?
What is the effectiveness percentage of Levonorgestrel when taken within 24 hours after unprotected sexual intercourse?
What is the effectiveness of Ulipristal when taken within 120 hours after unprotected sexual intercourse (UPSI)?
What is the effectiveness of Ulipristal when taken within 120 hours after unprotected sexual intercourse (UPSI)?
What is the primary reason for offering emergency hormonal contraception to women who have had unprotected sexual intercourse (UPSI)?
What is the primary reason for offering emergency hormonal contraception to women who have had unprotected sexual intercourse (UPSI)?
Considering the effectiveness of Levonorgestrel, which time frame corresponds to its effectiveness dropping significantly?
Considering the effectiveness of Levonorgestrel, which time frame corresponds to its effectiveness dropping significantly?
Which factor can render hormonal contraceptive methods less effective, necessitating the need for emergency contraception?
Which factor can render hormonal contraceptive methods less effective, necessitating the need for emergency contraception?
What is the essential timing for most women to access emergency hormonal contraception effectively?
What is the essential timing for most women to access emergency hormonal contraception effectively?
In which situation should a copper IUD be administered to a patient requiring emergency contraception?
In which situation should a copper IUD be administered to a patient requiring emergency contraception?
Which condition does NOT typically warrant the provision of emergency hormonal contraception?
Which condition does NOT typically warrant the provision of emergency hormonal contraception?
What is the ideal cycle length calculation for determining ovulation in women?
What is the ideal cycle length calculation for determining ovulation in women?
What documentation source is recommended for licensed indications regarding emergency contraception?
What documentation source is recommended for licensed indications regarding emergency contraception?
Under which circumstance should emergency hormonal contraception be provided after childbirth?
Under which circumstance should emergency hormonal contraception be provided after childbirth?
The Standards for Pharmacy professionals only apply when you are at University or on placement.
The Standards for Pharmacy professionals only apply when you are at University or on placement.
Who maintains the trust and confidence of patients and the public in pharmacy professionals?
Who maintains the trust and confidence of patients and the public in pharmacy professionals?
What are the Standards used for in Fitness to Practice enquiries?
What are the Standards used for in Fitness to Practice enquiries?
The GPhC and FtP will be covered in term ______ lectures.
The GPhC and FtP will be covered in term ______ lectures.
Where can you find further information about the Standards for Pharmacy professionals?
Where can you find further information about the Standards for Pharmacy professionals?
The Standards for Pharmacy professionals only apply while on university premises.
The Standards for Pharmacy professionals only apply while on university premises.
What regulatory body governs the standards expected of pharmacy professionals?
What regulatory body governs the standards expected of pharmacy professionals?
When are the Standards used in Fitness to Practice enquiries?
When are the Standards used in Fitness to Practice enquiries?
Where can further information about the Standards for Pharmacy professionals be found?
Where can further information about the Standards for Pharmacy professionals be found?
The GPhC and Fitness to Practice will be covered in term 1 lectures.
The GPhC and Fitness to Practice will be covered in term 1 lectures.
Flashcards
Sexual Health in England
Sexual Health in England
A framework for improving sexual health in England, focusing on eliminating stigma around sexual health issues, reducing STIs, unwanted pregnancies, HIV risks, and encouraging efficient quality services.
Emergency Hormonal Contraception (EHC)
Emergency Hormonal Contraception (EHC)
A type of contraception used after unprotected sex to prevent pregnancy.
Contraceptive Pill
Contraceptive Pill
A type of oral contraception to prevent pregnancy.
Chlamydia Infections
Chlamydia Infections
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Unwanted Pregnancies
Unwanted Pregnancies
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Conception Rate (2021)
Conception Rate (2021)
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Legal Abortions (2021)
Legal Abortions (2021)
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Pharmacy Role
Pharmacy Role
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Emergency Contraception (EC)
Emergency Contraception (EC)
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Levonelle One Step
Levonelle One Step
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EllaOne
EllaOne
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Patient Confidentiality
Patient Confidentiality
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Fraser Guidance
Fraser Guidance
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Emergency Hormonal Contraception (EHC)
Emergency Hormonal Contraception (EHC)
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Levonorgestrel (Plan B)
Levonorgestrel (Plan B)
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Ulipristal
Ulipristal
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Copper IUD
Copper IUD
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UPSI
UPSI
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Fertile Window
Fertile Window
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Ovulation Calculation
Ovulation Calculation
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Effectiveness of Levonorgestrel
Effectiveness of Levonorgestrel
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EHC Indications
EHC Indications
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Contraceptive Failure
Contraceptive Failure
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EHC for Under 13
EHC for Under 13
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IUD Effectiveness (EHC)
IUD Effectiveness (EHC)
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Levonorgestrel Effectiveness
Levonorgestrel Effectiveness
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Liver-Inducing Medications (EHC)
Liver-Inducing Medications (EHC)
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Weight Impact (EHC)
Weight Impact (EHC)
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Menstrual History (EHC)
Menstrual History (EHC)
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Pregnancy Possibility (EHC)
Pregnancy Possibility (EHC)
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Reason for Contraceptive Needs
Reason for Contraceptive Needs
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Sexual health stigma
Sexual health stigma
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Conception rate (2021)
Conception rate (2021)
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Unwanted pregnancy (2021)
Unwanted pregnancy (2021)
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Pharmacy sexual health role
Pharmacy sexual health role
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STIs & Screening
STIs & Screening
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Emergency Contraception (EHC)
Emergency Contraception (EHC)
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Contraceptive Pill (OTC)
Contraceptive Pill (OTC)
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Conceptions (2021)
Conceptions (2021)
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Levonelle One Step© (P Med)
Levonelle One Step© (P Med)
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EllaOne© (P Med)
EllaOne© (P Med)
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Emergency Contraception (EHC) initiation
Emergency Contraception (EHC) initiation
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Fraser Guidance (FSRH)
Fraser Guidance (FSRH)
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Age of Consent (UK)
Age of Consent (UK)
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EHC Time Frame (Levonorgestrel)
EHC Time Frame (Levonorgestrel)
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EHC Time Frame (Ulipristal)
EHC Time Frame (Ulipristal)
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EHC (Copper IUD) Time Frame
EHC (Copper IUD) Time Frame
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Fertile Window
Fertile Window
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Ovulation Calculation
Ovulation Calculation
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UPSI
UPSI
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EHC Indications
EHC Indications
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Reasons for EHC (Failure)
Reasons for EHC (Failure)
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Levonorgestrel Effectiveness
Levonorgestrel Effectiveness
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Ulipristal Effectiveness
Ulipristal Effectiveness
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EHC for Under 13
EHC for Under 13
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Reason for Contraceptive Needs
Reason for Contraceptive Needs
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Fraser Guidance
Fraser Guidance
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Levonorgestrel Effectiveness
Levonorgestrel Effectiveness
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Liver-Inducing Medications (EHC)
Liver-Inducing Medications (EHC)
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Weight Impact (EHC)
Weight Impact (EHC)
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Menstrual History (EHC)
Menstrual History (EHC)
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Pregnancy Possibility (EHC)
Pregnancy Possibility (EHC)
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Pharmacy Professional Standards
Pharmacy Professional Standards
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GPhC
GPhC
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Fitness to Practice
Fitness to Practice
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Standards - importance
Standards - importance
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OSPAP MPHM15
OSPAP MPHM15
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Pharmacy Professional Standards
Pharmacy Professional Standards
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GPhC
GPhC
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Fitness to Practice
Fitness to Practice
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Standards Importance
Standards Importance
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OSPAP MPHM15
OSPAP MPHM15
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Study Notes
OSPAP Programme: Sexual Health & Contraception
- Programme focuses on sexual health and contraception
- Learning outcomes cover the role of pharmacies in sexual health. Includes dispensing emergency hormonal contraception (EHC) and contraceptive pills, selling contraceptives over-the-counter (OTC), and considering ethical and legal aspects.
Learning Outcomes
- Describe the current role of pharmacy in sexual health
- Know how to conduct a consultation for oral emergency hormonal contraception (EHC) and contraceptive pills (NHS service).
- Know how to sell contraceptive pills OTC.
- Consider how pharmacies can support health protection related to Chlamydia infections.
- Examine ethical, legal, and professional considerations of providing sexual health services.
A Framework for Sexual Health Improvement in England (2013)
- Important issues in English sexual health:
- Stigma, discrimination, and prejudice related to sexual health.
- Reduction in sexually transmitted infections (STIs) through evidence-based screening and treatment.
- Reduction in unwanted pregnancies.
- Supporting women with unwanted pregnancies to make informed choices.
- HIV prevention, testing, diagnosis, and treatment in high-risk groups.
- Promote integration, quality, value for money, and innovation in sexual health interventions.
Conceptions in England and Wales (2021)
- The conception rate for women under 18 has halved since 2011.
- In 2021, the percentage of conceptions leading to legal abortions reached a record high of 26.5%.
- Women aged 30-34 had the highest conception rate and lowest percentage of conceptions leading to abortion.
Pharmacy Offer for Sexual Health, Reproductive Health, and HIV (2019)
- Improve access to sexual health services through convenient locations and flexible hours.
- Offer a local solution to sexual health, making these services more accessible.
- Making every contact count (MECC) approach utilized.
- Confidentiality and face-to-face consultation provided.
- Existing links with primary care and local sexual health providers utilized.
- Community Pharmacy is the primary access point for emergency hormonal contraception.
- Women face difficulties accessing GPs within 72 hours.
- Around half of UK pharmacies provide EHC services.
Indications for EHC (FSRH)
- Conception most likely occurs 5 days before ovulation and up to 2 days afterwards.
- Ovulation is calculated by subtracting 14 days from the cycle length.
- EHC should be offered to anyone who has had unprotected sex and does not want to conceive.
- EHC is available from day 21 after childbirth (if no conditions of lactational amenorrhoea apply).
- EHC is available from day 5 after miscarriage, abortion, ectopic pregnancy, or uterine evacuation.
Potential Reasons for EHC
- Failure to use any method of contraception.
- Contraceptive (barrier method) failure.
- Hormonal contraceptive method not effective (e.g., missed pills, late injection, IUD expulsion).
- Concurrent use of enzyme-inducing drugs.
Emergency Hormonal Contraception (EHC)
- Pharmacological: Levonorgestrel (up to 72 hours post-unprotected sex) and Ulipristal (up to 120 hours post-unprotected sex).
- Non-pharmacological: Copper-bearing intrauterine device (IUD).
Effectiveness of EHC (FSRH)
- Levonorgestrel is most effective within 24 hours (95%), less effective over time.
- Ulipristal is 98% effective within 120 hours.
- Copper IUD is 99% effective within 120 hours.
Consultation Skills
- The woman usually initiates the request for EHC.
- Pharmacists should put the woman at ease and listen.
- Pharmacists should be professional, compassionate, and non-judgmental.
- Pharmacists need to ask personal questions, but re-iterate the confidential nature of the consultation, particularly for those under 16.
Considering the Age of the Patient
- Legal age of sexual consent in the UK is 16.
- Unlawful sexual activity between two people under 16 is unlikely to lead to prosecution unless abuse or exploitation is suspected.
- Under 13's cannot legally consent to sexual activity.
- Consent for treatment under 16 using 'Fraser Guidance'.
- Safeguarding issues should be considered for all ages.
Fraser Guidance (FSRH)
- Legal framework for HCPs to treat young people under 16 without parental consent.
- 5 criteria that must be met:
- Young person understands advice.
- Young person is not persuadable to inform parents.
- Likely to continue sexual intercourse with or without contraception.
- Physical or mental health would suffer without contraception.
- Young person's best interests require contraception regardless of parental consent.
PGD Supply of EHC - PharmOutcomes
- Questions to ask the presenting person for EHC supply (1 & 2):
- Who is it for? Check they are over 13 (safeguarding).
- Reason for needing EHC (missed pill/failed contraception).
- Alcohol involved?
- Time since UPSI.
- OTC/herbal medicine?
- Patient >70kg?
- Menstrual history, cycle length, date of last period, day in cycle.
- Possibility of prior pregnancy.
- Exclusion criteria (e.g., thromboembolic conditions, malabsorption syndrome).
Copper-Bearing Intrauterine Device (IUD)
- First-line EHC, highly effective method.
- Prevents fertilization and implantation, safe for up to 5 days postpartum.
- Fitted by trained healthcare professional.
Supply on a Patient Group Direction
- Can supply EHC based on patient group directions.
- Availability varies based on local authority.
- Levonorgestrel can be supplied up to 72 hours post, Ulipristal up to 120 hours post.
- Ulipristal less effective if previously taking hormonal contraception.
EHC supply OTC
- Questions to ask about the person receiving EHC:
- Who is it for?
- Check they are over 16.
- Unprotected sex/failure of contraception within 72 or 120 hours?
- Possibility of recent pregnancy?
- Oral emergency contraception used recently?
Advice for EHC Supply
- Dose and administration (tablet or double dose).
- Side effects (nausea, bleeding etc).
- Potential effect on fetus.
- STI awareness.
- Medical advice, when needed.
- Future contraception.
- Breastfeeding information (levonorgestrel is excreted in breast milk, ulipristal not recommended).
Ethics Associated with EHC
- Consider location and services available when accepting employment providing EHC.
- Be open and honest about refusing to provide a service.
- Handle situations sensitively when refusing, and signpost patients to alternatives.
EHC Through Community Pharmacies
- Pharmacies provide better access to EHC compared to clinical settings.
- Women attend pharmacies within 24 hours more often.
- Some inadequacies identified in regard to privacy, safety and information provision in pharmacies.
Condoms (FSRH)
- Two types; condoms offer ~98% effectiveness; femdoms ~95%.
- Prevention of STIs.
- Wide range available; encouraged users to explore choices.
- NHS sexual health clinics for free condoms and advice.
Sexual Health Advice
- Shows the interconnection between contraception, copper coil IUD's and Chlamydia, and condoms.
Role of Pharmacy in Sexual Health
- Evidence shows high public interest and demand for advice on contraception and safe sex through pharmacies.
- Quality and confidentiality are important considerations people look for in pharmacies.
- Pharmacists support safer sex, but reluctance to offer advice is observed.
- Pharmacists generally show positive attitudes towards infection prevention and treatment.
- Community involvement in prevention services increased by client access.
OTC Regular Contraception
- Brands Hana and Lovima (desogestrel) available since 2021.
- Can be purchased after a short consultation with a pharmacist, for £10-£20.
- Available with pharmacist information and training.
Contraception (New NHS Pharmacy Service)
- New NHS service for repeat oral contraception in April 2023 (Tier 1).
- Tier 2 (Dec '23) - initiation of oral contraception by Patient Group Direction (PGD).
- Initial prescriptions maximum 3 months duration.
- Ongoing provision maximum 12 months.
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Description
This quiz tests your knowledge of emergency hormonal contraception, including the time frame for administering EllaOne, consultations for pharmacists, and legal considerations regarding young persons under 16. Understand the safeguarding issues related to patients of all ages and the laws stipulating consent in the UK.