Improving effective contraception uptake through provision of bridging contraception within community pharmacies: findings from the Bridge-it Study process evaluation

Patterson, S. et al. (2022) Improving effective contraception uptake through provision of bridging contraception within community pharmacies: findings from the Bridge-it Study process evaluation. BMJ Open, 12, e057348. (doi: 10.1136/bmjopen-2021-057348) (PMID:35149574) (PMCID:PMC8845311)

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Abstract

Objective: To present process evaluation results from the Bridge-it Study, a pragmatic cluster randomised cross-over trial to improve effective contraception uptake through provision of the progestogen only pill (POP) plus sexual and reproductive health (SRH) clinic rapid-access to women presenting to community pharmacies for emergency contraception (EC). Research: design and methods A multimethod process evaluation was conducted to assess intervention implementation, mechanisms of change and contextual factors. Data were gathered from screening logs (n=599), observations of pharmacist training, analysis of data from 4-month follow-up questionnaires (n=406), monitoring of contemporaneous events and qualitative interviews with 22 pharmacists, 5 SRH clinical staff and 36 study participants in three participating UK sites in Lothian, Tayside and London. Results: The intervention was largely delivered as intended and was acceptable. Pharmacists’, SRH clinical staff and participants’ accounts highlighted that providing a supply of POP with EC from the pharmacy as routine practice may have positive impacts on contraceptive practices in the short term, and potentially longer term. Key mechanisms of change included ease of access, increased awareness of contraception and services, and greater motivation and perceptions of self-efficacy. Few participants took up the offer to attend an SRH service (rapid-access component), and existing barriers within the SRH context were apparent (eg, lack of staff). Participant accounts highlight persistent barriers to accessing and using routine effective contraception remain. Conclusions: Implementation appeared to be acceptable and feasible, highlighting the potential for provision of POP within EC consultations as routine practice in community pharmacies. However, lack of engagement with the rapid access component of the intervention and existing barriers within the SRH context suggest that signposting to SRH services may be sufficient. Wider implementation should consider ways to address key implementation challenges to increase effectiveness and sustainability, and to overcome persistent barriers to accessing and using effective contraception.

Item Type:Articles
Additional Information:Funding for the research was provided by the National Institute for Health Research’s Health Technology Assessment Programme. HTA Project: 15/113/01. LM and SP are funded by the UK Medical Research Council and Chief Scientist Office of the Scottish Government Health and Social Care Directorates at the MRC/CSO Social & Public Health Sciences Unit, University of Glasgow (MC_UU_12017/11, SPHSU11; MC_UU_00022/3, SPHSU18).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McDaid, Professor Lisa and Saunders, Dr Kristina and Patterson, Mrs Susan
Authors: Patterson, S., McDaid, L., Saunders, K., Battison, C., Glasier, A., Radley, A., Stephenson, J. M., Johnstone, A., Morelli, A., Sally, D., Stewart, N., and Cameron, S. T.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:11 February 2022
Copyright Holders:Copyright © Author(s) (or their employer(s)) 2022
First Published:First published in BMJ Open 12: e057348
Publisher Policy:Reproduced under a Creative Commons licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
174342A randomised controlled trial to determine the effectiveness of bridging from emergency to regular contraception: The 'Bridge-it' study TRIAL CI - PROFESSOR SHARON CAMERONLisa McDaidNational Institute for Health Research (NIHR)15/113/01HW - MRC/CSO Social and Public Health Sciences Unit
727631Social Relationships & Health ImprovementLisa McDaidMedical Research Council (MRC)MC_UU_12017/11HW - MRC/CSO Social and Public Health Sciences Unit
3048231Relationships and healthKirstin MitchellMedical Research Council (MRC)MC_UU_00022/3HW - MRC/CSO Social and Public Health Sciences Unit
727631Social Relationships & Health ImprovementLisa McDaidChief Scientist Office (CSO)SPHSU11HW - MRC/CSO Social and Public Health Sciences Unit
3048231Relationships and healthKirstin MitchellChief Scientist Office (CSO)SPHSU18HW - MRC/CSO Social and Public Health Sciences Unit