Electronic letters to:

Research:
Judith A. Soon, Marc Levine, Brenda L. Osmond, Mary H.H. Ensom, and David W. Fielding
Effects of making emergency contraception available without a physician's prescription: a population-based study
CMAJ 2005; 172: 878-883 [Abstract] [Full text] [PDF]
*eLetters: Submit a response to this article

Electronic letters published:

[Read eLetter] OPA Respond to Plan B Editorial
Jane Farnham   (6 April 2005)

OPA Respond to Plan B Editorial 6 April 2005
Top
Jane Farnham
Chair, Ontario Pharmacists' Association

Send letter to journal:
Re: OPA Respond to Plan B Editorial

chair{at}opatoday.com Jane Farnham

April 5th, 2005

Mr. John Hoey, Editor, Canadian Medical Association Journal

Dear Editor:

There has been much controversy about the decision to make Emergency Contraception (EC) available to women without a doctor's prescription. Our organization believes that your editorial on this issue was way off the mark, incorrectly asserting that the pharmacist may be a barrier to women's access to what some call the "morning-after pill" which is marketed as PLAN B (Levornorgestrel).

As both a pharmacist and a woman, I think it is time to set the record straight.

First of all, Health Canada should be applauded for its decision to provide more timely access to PLAN B. This decision was made after much study and consultation and is consistent with what is happening in many other countries.

Emergency contraception has historically only been available by prescription. That has meant that women seeking access to EC have had to see their doctor or go to an emergency room to get access this medication with all the accompanying delays. A pilot program to eliminate the need for a physician consultation was recently evaluated in British Columbia. Pharmacists interviewed patients, counseled on effectiveness and appropriate use, and provided the medication.. The study showed clearly that trained pharmacists enhanced the availability of EC. This is not surprising, given that the pharmacist is the most accessible of front line health care providers.

To expand this access to women across Canada, Health Canada decided that removing the need for physician consultation while preserving the pharmacist consultation will allow women to receive the necessary professional service while ensuring appropriate use. This proposal is supported by the Society of Obstetricians and Gynecologists of Canada.

Secondly, let's deal with the need for consultation. Do women need advice on EC? The statistics say they do. Levornorgestrel is not a benign drug. Pharmacists at the Drug Information and Research Centre (DIRC) operated by the Ontario Pharmacists' Association respond to over 70,000 calls per year from health professionals and the public.

Women have many questions about the need for emergency contraception (EC), how best to access the product, possible side effects and potential interactions with drug or herbal medications. Many are in a state of anxiety and stress. We are there to provide advice in a timely way in accordance with our training.

I firmly believe that a trained health care professional is needed to counsel about how this medication works, how to use it most effectively and how to deal with any side effects that might occur like vomiting or cramps. Pharmacists also provide counseling about sexually transmitted infections (STI's), advise that EC should not be used as regular birth control and refer women to other professionals as necessary.

Thirdly, I take issue with those who say pharmacists might be a barrier to timely access for women. Let me be clear about one thing. Pharmacists are first and foremost, advocates for quality patient care and wellbeing. We are trained as medication experts and we must and we do adhere to the highest standards in the treatment of our patients. People trust us because we have earned that trust.

Counseling on medication isn't paternalistic as some suggest. It's essential to ensure that patients understand what they are taking, as well as the expected benefits and potential risks.

Finally, we also believe that EC is a medically necessary service that should be covered by private and public drug plans. That's good public policy.

To follow the logic of some critics, perhaps Plan B should be sold at the local gas bar. In my view, that's just bad public policy and is not in the best interests of women's health.

Jane Farnham, Chair of the Board