Pharmacies Often Misinform Teens on Emergency Contraception

Rod Franklin

March 28, 2012

March 28, 2012 — A telephone survey in which "mystery" callers posing either as 17-year-old girls or as physicians seeking advice on how to quickly obtain emergency contraception (EC) has demonstrated that pharmacies often dispense inaccurate information concerning the legal availability of levonorgestrel, according to the results of a study published online March 26 and in the April print issue of Pediatrics.

Research conducted by Tracey A. Wilkinson, MD, from the Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Massachusetts, and colleagues showed that of 943 pharmacies called twice in 5 US cities, there was a consistent response to the first of 3 questions (whether or not EC would be immediately available that day), with 80% (759) of the adolescent callers being told "yes" compared with 81% (766) of the physician callers. However, in response to a second question, which specified age, pharmacy personnel more often stated incorrectly that EC would not be available to a 17-year-old when the caller posed as a teenager than when the caller claimed to be a physician.

Nineteen percent (145) of the pharmacies conveyed the incorrect response to adolescent callers who said they were 17 years old compared with 3% (23) of the calls claiming to be from physicians inquiring on behalf of a 17-year-old patient (P < .0001).

The telephone survey, which focused on pharmacies in Nashville, Tennessee; Philadelphia, Pennsylvania; Cleveland, Ohio; Austin, Texas; and Portland, Oregon, sought to address the issue of delays in cases where rapid access to EC might successfully halt an unwanted pregnancy. The researchers note that 85% of the approximately 750,000 teenage pregnancies reported each year are unintended, but observe that about half of these could be prevented under a 2009 law that makes EC available to individuals aged 17 years or older without a prescription.

Access and correct information from pharmacies is crucial, the study's authors write, because a teenage girl's failure to ingest EC increases the odds of pregnancy by nearly 50% with each 12 hours that pass after unprotected intercourse.

The probe demonstrated that inaccurate information often is dispensed when a pharmacy is asked specifically about the legal cutoff age for EC without a prescription. This question was asked to more explicitly query the pharmacy's knowledge, even when the adolescent or physician was informed that the party in need would be able to obtain the drug as a 17-year-old. The correct age for dispensation of EC without a prescription was given to 61% (466) of physician callers and 57% (431) of the adolescent callers.

Adolescent callers were asked to wait more often than physicians as pharmacy personnel sought to retrieve the age-restriction answer, with 54% of adolescent callers put on hold compared with 26% of physician callers.

Most pharmacies reported that they had EC in stock. In cases where it was not available, however, the pharmacy personnel failed to recommend alternate sources of the drug in 36% of the inquiries from adolescents and 33% of the calls from physicians.

The authors have disclosed no relevant financial relationships.

Pediatrics. Published online March 26, 2012. Full text

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