Emergency Contraception Guidelines Quiz
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Questions and Answers

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?

  • 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?

  • 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?

    <p>13 years old</p> Signup and view all the answers

    What is the general approach regarding safeguarding issues for patients of all ages according to the provided guidelines?

    <p>They should be considered at all ages</p> Signup and view all the answers

    What is one of the primary goals in addressing sexual health issues in England according to the framework?

    <p>Reduce unwanted pregnancies and support informed choices</p> Signup and view all the answers

    Which age group showed the highest number and conception rate for five consecutive years as of 2021?

    <p>Women aged 30 to 34 years</p> Signup and view all the answers

    Which of the following issues is NOT highlighted as a significant challenge in sexual health in England?

    <p>Limited availability of contraception methods</p> Signup and view all the answers

    What record percentage of conceptions led to legal abortion in 2021?

    <p>26.5%</p> Signup and view all the answers

    Which of the following statements correctly represents a change in conception rates among young women in England since 2011?

    <p>The conception rate for women under 18 years has more than halved</p> Signup and view all the answers

    What is emphasized as vital in providing sexual health services at pharmacies?

    <p>Understanding ethical, legal, and professional considerations</p> Signup and view all the answers

    What is one of the methods promoted to reduce the rate of STIs in England?

    <p>Evidence-based screening and treatment</p> Signup and view all the answers

    Which of the following best describes the trend regarding unwanted pregnancies according to the framework?

    <p>There is a need to reduce and support informed choices</p> Signup and view all the answers

    What is the effectiveness percentage of Levonorgestrel when taken within 49-72 hours after unprotected sexual intercourse (UPSI)?

    <p>58%</p> Signup and view all the answers

    Which of the following is NOT a potential reason for needing emergency hormonal contraception (EHC)?

    <p>Successful experience with a long-term IUD</p> Signup and view all the answers

    How many pharmacies in the UK provide the Emergency Hormonal Contraception (EHC) service?

    <p>Around half</p> Signup and view all the answers

    What is the recommended double dose of Levonorgestrel for some patients?

    <p>3.0mg</p> Signup and view all the answers

    When should emergency hormonal contraception (EHC) be offered to women after childbirth?

    <p>From Day 21 after childbirth</p> Signup and view all the answers

    What is the maximum time frame for using Ulipristal after UPSI to maintain its effectiveness?

    <p>120 hours</p> Signup and view all the answers

    Which of the following is a non-pharmacological form of Emergency Contraception (EC)?

    <p>Copper IUD</p> Signup and view all the answers

    What is the ideal timing for most effective use of emergency hormonal contraception after UPSI?

    <p>Within 5 days</p> Signup and view all the answers

    Which enzyme-related condition can affect the effectiveness of hormonal contraceptives?

    <p>Enzyme-inducing drugs</p> Signup and view all the answers

    What is the effectiveness percentage of the Copper IUD when used within 120 hours after UPSI?

    <p>99%</p> Signup and view all the answers

    Which of the following is NOT one of the five criteria that must be satisfied regarding a young person receiving contraceptive treatment?

    <p>The young person must be over 16 years old</p> Signup and view all the answers

    What is the effectiveness of levonorgestrel when taken within 24 hours after unprotected sexual intercourse (UPSI)?

    <p>95%</p> Signup and view all the answers

    When assessing the menstrual history of a patient seeking emergency hormonal contraception, which factor is NOT relevant?

    <p>Current body weight</p> Signup and view all the answers

    What should a healthcare professional consider when a patient presents for emergency hormonal contraception and is over 70kg?

    <p>They require a double dose of levonorgestrel</p> Signup and view all the answers

    If a young person cannot be persuaded to inform their parents, which aspect of their situation is being addressed?

    <p>Their need for parental consent</p> Signup and view all the answers

    Which of the following scenarios would NOT be a valid reason for a person to seek emergency hormonal contraception?

    <p>Desire for regular contraceptive method</p> Signup and view all the answers

    What should be determined about the patient's menstrual cycle before supplying emergency hormonal contraception?

    <p>Whether their last period was normal</p> Signup and view all the answers

    When discussing potential pregnancy with a patient, which factor should be assessed?

    <p>Current stage of their menstrual cycle</p> Signup and view all the answers

    What is the primary age restriction for accessing Levonelle One Step®?

    <p>Must be over 16 years old</p> Signup and view all the answers

    Which of the following statements is true regarding the Fraser Guidance?

    <p>It provides a legal framework for treating young persons under 16 without parental consent.</p> Signup and view all the answers

    How does the law in the UK define consent for sexual activity in individuals under 16?

    <p>Mutual sexual activity between two under 16s is lawful unless abuse is suspected.</p> Signup and view all the answers

    What is a critical consideration during consultations for emergency hormonal contraception?

    <p>Assuring the confidentiality of the consultation.</p> Signup and view all the answers

    What is the maximum time frame for using Ulipristal after UPSI to ensure its effectiveness?

    <p>120 hours</p> Signup and view all the answers

    What is a key issue that the framework for sexual health improvement in England aims to address?

    <p>Reducing stigma and discrimination associated with sexual health</p> Signup and view all the answers

    Which strategy is emphasized to reduce unwanted pregnancies in England?

    <p>Providing comprehensive sexual education</p> Signup and view all the answers

    What was the reported trend for the conception rate among women under 18 years in recent years?

    <p>It has significantly declined since 2011</p> Signup and view all the answers

    What percentage of conceptions leading to abortion reached a record high in 2021?

    <p>26.5%</p> Signup and view all the answers

    What role do pharmacies play in health protection concerning Chlamydia infections?

    <p>Providing information and screening services</p> Signup and view all the answers

    What is one of the priorities for HIV prevention and treatment in high-risk groups?

    <p>Improving testing, diagnosis, and treatment access</p> Signup and view all the answers

    Which aspect is crucial for pharmacies when providing sexual health services?

    <p>Understanding ethical, legal, and professional considerations</p> Signup and view all the answers

    What is the goal related to STIs as outlined in the framework for sexual health improvement in England?

    <p>To promote evidence-based screening and treatment</p> Signup and view all the answers

    Which criterion indicates that a young person is likely to suffer if not provided with contraceptive treatment?

    <p>Their physical or mental health may deteriorate.</p> Signup and view all the answers

    What is a crucial question to ask regarding a patient's history before providing emergency hormonal contraception?

    <p>Are you currently taking any liver-inducing medications?</p> Signup and view all the answers

    What specific factor impacts the effectiveness of Levonorgestrel for patients weighing over 70kg?

    <p>They require a double dose of Levonorgestrel.</p> Signup and view all the answers

    Which of the following should be determined about a patient's menstrual cycle when assessing the need for emergency hormonal contraception?

    <p>The regularity of their cycle.</p> Signup and view all the answers

    What does the Fraser Guidance allow regarding young persons under 16 seeking contraceptive treatment?

    <p>They can provide consent themselves for treatment if certain conditions are met.</p> Signup and view all the answers

    In the context of emergency hormonal contraception, what does UPSI stand for?

    <p>Unprotected Sexual Intercourse.</p> Signup and view all the answers

    What aspect of a young person's situation is specifically addressed if they are resistant to informing their parents?

    <p>Their likelihood to follow professional advice.</p> Signup and view all the answers

    What is the effectiveness percentage of Levonorgestrel when taken within 24 hours after unprotected sexual intercourse?

    <p>95%</p> Signup and view all the answers

    What is the effectiveness of Ulipristal when taken within 120 hours after unprotected sexual intercourse (UPSI)?

    <p>98%</p> Signup and view all the answers

    What is the primary reason for offering emergency hormonal contraception to women who have had unprotected sexual intercourse (UPSI)?

    <p>To prevent conception after UPSI</p> Signup and view all the answers

    Considering the effectiveness of Levonorgestrel, which time frame corresponds to its effectiveness dropping significantly?

    <p>Within 49-72 hours</p> Signup and view all the answers

    Which factor can render hormonal contraceptive methods less effective, necessitating the need for emergency contraception?

    <p>Concurrent use of enzyme-inducing drugs</p> Signup and view all the answers

    What is the essential timing for most women to access emergency hormonal contraception effectively?

    <p>Within 72 hours of UPSI</p> Signup and view all the answers

    In which situation should a copper IUD be administered to a patient requiring emergency contraception?

    <p>Within 120 hours of UPSI</p> Signup and view all the answers

    Which condition does NOT typically warrant the provision of emergency hormonal contraception?

    <p>Regular menstrual cycle</p> Signup and view all the answers

    What is the ideal cycle length calculation for determining ovulation in women?

    <p>Cycle length minus 14 days</p> Signup and view all the answers

    What documentation source is recommended for licensed indications regarding emergency contraception?

    <p>Manufacturer's Product Information</p> Signup and view all the answers

    Under which circumstance should emergency hormonal contraception be provided after childbirth?

    <p>After Day 21 postpartum</p> Signup and view all the answers

    The Standards for Pharmacy professionals only apply when you are at University or on placement.

    <p>False</p> Signup and view all the answers

    Who maintains the trust and confidence of patients and the public in pharmacy professionals?

    <p>Pharmacy professionals</p> Signup and view all the answers

    What are the Standards used for in Fitness to Practice enquiries?

    <p>Examples of what is expected of pharmacy professionals</p> Signup and view all the answers

    The GPhC and FtP will be covered in term ______ lectures.

    <p>2</p> Signup and view all the answers

    Where can you find further information about the Standards for Pharmacy professionals?

    <p>MPHM15 module page</p> Signup and view all the answers

    The Standards for Pharmacy professionals only apply while on university premises.

    <p>False</p> Signup and view all the answers

    What regulatory body governs the standards expected of pharmacy professionals?

    <p>GPhC</p> Signup and view all the answers

    When are the Standards used in Fitness to Practice enquiries?

    <p>As examples of what is expected at all times</p> Signup and view all the answers

    Where can further information about the Standards for Pharmacy professionals be found?

    <p>MPHM15 module page</p> Signup and view all the answers

    The GPhC and Fitness to Practice will be covered in term 1 lectures.

    <p>False</p> Signup and view all the answers

    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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    Related Documents

    Sexual Health & Contraception PDF
    OSPAP MPHM15 Code of Conduct PDF

    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.

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