Christie Hayes told Mamamia her morning after pill story, and the pharmacist’s response left her outraged.
Now another pharmacist, Jarrod McMaugh, who was disappointed by the situation wants to help set the record straight on what you should expect if you need the morning after pill.
The lowdown:
“You have a right to access ‘over the counter’ medications, and the pharmacist has an obligation to ensure that these medications are safe for you, and will be effective.
Your partner (or any third party you choose) can purchase on your behalf – in this case, the pharmacist should contact you directly by phone to discuss all of the issues with you. A third party can’t answer questions for you, and they can’t be relied upon to deliver all of the information you need to know.
Emergency contraception is most effective within 24 hours, but can be very effective and safe up to five days after unprotected sex.
There are some cases where emergency contraception won’t work for you, and your pharmacist will recommend another course of action in these instances.”
What is emergency contraception?
“Broadly speaking, it covers any intervention after sexual intercourse that prevents pregnancy. The important thing to remember is that these interventions prevent pregnancy – in the case of Levonorgestrel, if a woman is already pregnant, taking the medication will not affect the pregnancy.
“Emergency contraception is most effective within 24 hours. Levonorgestrel is considered effective up to three days after sex, while Ulipristal can be used up to five days after sex. For this reason, the term “morning after” is a little misleading, but if possible, acting within 24 hours will be the most effective course of action.
About “over the counter” medications
“The term “over the counter” is used to refer to medications that can be purchased without a prescription. What is important to remember is that many medications still require significant clinical input from a pharmacist – this is referred to as “Schedule 3”.
“Medications are often put in to schedule 3 for one of three broad reasons – There is a potential for abuse, the medication has a high potential for side effects, or the condition being treated requires clinical skills to determine the correct course of treatment (emergency contraception falls into this point).
“In all of these cases, there is a requirement for the pharmacist to communicate directly with the patient in order to determine the best course of action.
Can your partner purchase emergency contraception on your behalf?
“Despite Christie Hayes’ experience, there is no reason that a person who requires this medication can’t have a third party purchase it on their behalf – but there are a few things that need to happen to ensure the supply is appropriate.
“First and foremost, the pharmacist will need to speak to you. This will mean they will ask your partner (or whoever else you have helping you) for your phone number, and they will call you. They will check that you are the person that requires the medication, and then they will ask you a few questions, such as:
- Your name
- Your age
- What type of contraception you normally use
- Whether you could already be pregnant from a previous sexual encounter
- If you take other medications
- If you have a history of some health conditions.
- Your weight
“The pharmacist will then discuss with you how the medication will help, how to take it, and what to expect from the medication. Once this has occurred, your third-party purchaser will be able to bring you the medication.
“All of your data is private and only you can access that data.
What else you should know
“I advise my patients to do a pregnancy test after they have used a form of emergency contraceptive – usually a few days to a week later. It is important to remember that Levonorgestrel and Ulipristal do not affect an existing pregnancy, so if your pregnancy test comes back positive, another dose won’t be of any use. Based on this, I advise my patients to either come back to me for a referral, or to speak directly to their doctor. There are medications available that can be used to end an early pregnancy that require a prescription.
“Emergency contraception may cause nausea, and in rare cases where vomiting occurs, this can reduce the effectiveness – as a rule of thumb, any medication will likely be lost if vomiting or diarrhoea occurs within an hour of taking medication. If this occurs, it would be best to see a doctor as they can provide a prescription for medication that will prevent a second dose from being lost.”
For more from Jarrod McMaugh, B.Pharm MPS, you can follow him on Twitter.
Top Comments
Jarrod, I mentioned this to you on the other thread in AJP. If the patient can come in, they should. You should have stressed this in your article. I work in an extremely busy pharmacy dispensing up to 1000 scripts a day. At any time i'm dealing with urgent issues, dozens of scripts and dozens of other requests for S3s. Ofcourse I do everything in my power to call the patient but I cannot be expected to ignore the patients infront of me to call people purely because it was inconvenient or too cold for them to come in. Calling is more time consuming than having that person infront of you, especially if they don't answer or the line is poor.
Also, this article sounds as though we have to call patients when the third party presents which I'm fairly confident is not the case, if it is, can you please point me to the legislation that states we have to call the patient when the third party presents? Ofcourse I will do it as most Pharmacists will because we want them to have the medication, but this should be a last resort when the patient absolutely can't come in, not purely for convenience.
Convenience for the patient means inconvenience for the Pharmacist who is already working under pressure. It is not fair to expect Pharmacists to take a gamble and do phone consults and hope the person needing the medication actually gets It. It is our registration on the line and if there is uncertainty on our end, it's not a fair position to put us in. Phone consults should be the last resort and for situations where the patient absolutely cannot present.
There are no requirements for a pharmacist to call (or take a call) from a patient regarding a schedule 3 medication.
This doesn't mean that a pharmacist shouldn't do this - but there is a duty of care to a patient once they have sought your treatment, even if it is via a third party.
With regards to your workload - there are limits to the workload that a pharmacist is expected to undertake. i would assume that the 1000 prescriptions a day are not being processed by yourself alone...?
So good to see all of this cleared up - I'm sure the knowledge that the pharmacist can talk to you over the phone and then give the medication to a third party will help avoid situations where women are unable to access the medication promptly as mentioned in the other articles.