CONCERNS AND CAUTIONS ABOUT PRESCRIBING AND DEREGULATING EMERGENCY CONTRACEPTION - A QUALITATIVE STUDY OF GPS USING TELEPHONE INTERVIEWS

Objectives. We aimed to describe GPs' responses to a clinical scenario of a request for a repeat prescription for hormonal emergency contrac eption (EC), their views about over-the-counter availability and belie fs about absolute contraindications. Design. We conducted semi-structu red tape-recorded telephone interviews with 76 GPs randomly selected f rom the medical registers of three health authorities which were chose n for high, medium and low prescribing rates for EC. Results. There wa s a wide variation in the number of times that GPs would be happy to p rescribe EC to the same woman in a year. The content of the consultati ons appeared patchy. While 59 (77.6%) of the GPs said that they would discuss future contraception with the woman, only 16 (27.1%) said they would talk about possible side effects and 28 (36.3%) would discuss t he timing of the next menstrual period and the possibility of method f ailure. Fifty-two of the practices had a family-planning-trained pract ice nurse, yet only four (7.7%) had arrangements whereby the nurse cou ld provide EC. Unqualified enthusiasm for deregulation was rare. Conce rns included that women would lose out on the benefits of the consulta tion; worries about the safety of the method; that some women might 'a buse' it by using it frequently; and that certain characteristics of t he pharmacy might make it an unsuitable setting for provision of EC. C onclusions. This qualitative telephone survey revealed concerns about repeated use of EC and caution about the prospects of deregulation. Re spondents were worried that pharmacists might not be able to address a ll of the features of the consultation that may be valued, yet in this sample nor do most GPs. Family-planning-trained practice nurses are a n under-utilized resource and could act as a halfway house between pro vision by GPs and deregulation.