The Feasibility and Effectiveness of the Provision of Alcohol Screening and Brief Advice in Pharmacies for Women Accessing Emergency Contraception (EHOC)

Background potential of community pharmacies as a setting for health promotion advice gap in the evidence on screening and brief advice in a pharmacy setting pilot in County Durham and Darlington for women accessing community pharmacy for EHOC funded by PCT and DH the Evaluation, Research and Development Unit (ERDU) at Durham University agreed to evaluate the initiative

Strands of the evaluation 1.Interviewing pharmacists about the implementation and acceptability of the initiative 2.Interviewing clients identified as ‘low risk’ to understand their perceptions of the initiative 3.On-line surveys with the ‘risky’ group to evaluate the impact of the initiative on alcohol consumption and contraceptive behaviour as well as their perceptions of the initiatives

Process

Study procedure

Project Timeline

Promotional campaign

Key Findings uptake by pharmacists was low initially. in first 6 months only 26 pharmacists took up training and only 13 were regularly screening clients by Nov 2011 the number had doubled as HCAs could assist (NICE) and participants were offered a voucher for participating in the study (3/6 month follow up) barriers included time, conflicting demands, confidence with the AUDIT tool, raising a sensitive topic with clients

Key Findings mean age was 21.9years (range from years) there was an increase in AUDIT score between baseline and 3 months however the mean difference in AUDIT score between 3 and 6 months reduced by points (need a larger sample) after 3 months follow up no women reported having used EHOC again after the intervention, though 4 did at 6 months. However increase in use of oral contraception and LARCs.

Key Findings at baseline 12 women reported they had sex they regretted, only 3 reported this at 6 months follow up. at baseline 3 women reported they has sex that was forced on them/non-consensual and none at 6 month follow up clients felt it was appropriate and acceptable for the pharmacist to carry out alcohol screening and deliver alcohol advice

Strengths and limitations need consistency in data collection method i.e. face to face then on-line fewer participants/pharmacists were recruited than anticipated the mean change in AUDIT score was significant but small, results have to be interpreted with caution given the large CIs fees were not an incentive for pharmacies, they felt they were making a difference rather than just giving out medication

Next Steps expansion of the scheme to cover more conditions which may be associated with alcohol misuse including gastric problems, falls, high blood pressure, depression/anxiety/stress, pregnancy or for MURs 86 pharmacists now trained to deliver alcohol screening (74 County Durham and 12 Darlington) regular use of AUDIT has increased skills of pharmacists links to annual campaigns in particular in alcohol awareness week