Contraception and pregnancy planning needs of women receiving opiate substitution treatment: can community pharmacy fill the gap?

First published: 13/03/2019 | Last updated: March 28th, 2019

Dr Hannah Family

Lecturer

I’ve been working in the field of pharmacy and health services research since 2008 when I joined the department of Pharmacy and Pharmacology at the Univeristy of Bath. Initially I joined the department as a research assistant, realising the many opportunities for psychologists in this field I decided to undertake a PhD with the team. The focus of my thesis was the impact that workload, and in particular mental workload (which is an index of how much work our cognitive processes are undertaking in any given moment) and whether this could be related to errors in routine tasks carried out by community pharmacists and their teams. I completed my PhD at the end of 2013 and since this time I have been working as a lecturer in the same department providing training to Master of Pharmacy students in consultation skills, human factors for patient safety, health psychology and behaviour change. For two years (Nov 2011-Dec 2013) I was Chair Elect and subsequently Chair of the South West of England Branch of the British Psychological Society. This involved leading a team of 30 remotely located volunteers, between us we held over 100 networking events, talks and conferences for psychologists and individuals interested in psychology around the south west, we also produced a quarterly publication for the society and delivered careers events to schools around the South West of England. In this role I was also able to contribute to national work being carried out by the British Psychological Society.



Aims: Previous research suggests that some women receiving opiate substitution treatment (WRO) can fall through the gaps with regards to preconception counselling and contraception support. This study aimed to explore the contraception and pregnancy planning needs of WRO and whether community pharmacies (CPs) would be an acceptable and feasible place for WRO to receive this support.

Methods: 40 WRO aged between 22 and 49 years were recruited through drug and alcohol services in the south west and south east of England. Face-to-face semi-structured interviews were conducted, transcribed verbatim, and analysed via Framework.

Results: Over half (n=23) were not using contraception, of which most were sexually active and not planning to conceive. Contraceptive preferences and barriers to use were discussed. Twelve wished to conceive in the future, when their lifestyles were more stable, and two were currently pregnant. WRO were receptive to CPs providing contraception or pregnancy advice, but worried about pharmacists raising the topic without being asked: “I would think ‘what are you trying to imply?’” [WRO 23]. Although open to CP support many felt the most acceptable setting was their drug and alcohol service where they were better known. A few WRO felt that the pharmacists’ workload made this support infeasible.

Conclusions: For CPs to offer such support to WRO, the way the service is introduced needs to be considered, to ensure WRO are not offended when the topic is raised. Opportunities for CP and drug and alcohol services to work together to provide this support should be considered.

 

Dr Hannah Family