Introducing a “same day referral” program for post-coital IUD insertion in Ontario: A mixed-methods study with pharmacists
Bibliographic record
Abstract
Objectives:Post-coital insertion of the Copper-T intrauterine device (IUD) is the most effective method of emergency contraception (EC). However, few women use this method of pregnancy prevention in Canada. Our study aimed to explore Ontario pharmacists’ knowledge of the IUD as EC and interest in a hypothetical “same day referral” program that would provide women seeking progestin-only EC with information about and a timely referral for post-coital IUD insertion.Methods: We received 198 mailed surveys from representatives of Ontario pharmacies and conducted 17 in-depth interviews with a subset of respondents in 2015. We analyzed the survey data using descriptive statistics and interviews for content and themes using both deductive and inductive techniques.Results:Our results suggest that Ontario pharmacists underestimate the efficacy of the IUD as EC and lack awareness of the protocols for use. Survey respondents and interviewees expressed support for a “same day referral” program in Ontario and believe more effective methods of EC should be easily accessible. Interviewees discussed current barriers to the use of IUDs as EC, including the up-front costs associated with insertion and a general lack of awareness about EC among health professionals and communities.Discussion: There is a significant need for continuing education on the full range of EC methods among pharmacists. Considerable enthusiasm exists for undertaking efforts to expand access to more effective EC methods. Developing a pilot project to facilitate timely referrals for post-coital IUD insertion appears warranted.RésuméObjectifs : L’insertion postcoïtale d’un dispositif intra-utérin (DIU) au cuivre est la méthode la plus efficace de contraception d’urgence (CU). Toutefois, peu de femmes au Canada utilisent cette méthode de prévention de la grossesse. Notre étude visait à explorer les connaissances des pharmacien(ne)s ontarien(ne)s sur le DIU utilisé comme CU, ainsi que leur intérêt pour un programme hypothéque d’orienta on du même jour, qui fournirait en temps opportun de l’information et une insertion postcoïtale d’un DUI aux femmes désirant une CU à progestatif seul. Méthodes : Nous avons reçu 198 sondages par la poste de la part de représentants de pharmacies ontariennes, et avons mené 17 entrevues détaillées avec un sous-ensemble des répondants en 2015. Nous avons analysé les données de l’enquête à l’aide de statisques descriptives, ainsi que le contenu et les thèmes des entrevues au moyen de méthodes déductives et inductives. Résultats : Nos résultats indiquent que les pharmacien(ne)s de l’Ontario sous-estiment la capcacité du DIU utilisé comme CU et ne connaissent pas les protocoles nécessaires. Les répondants à l’enquête et les sujets interrogés ont exprimé leur soutien au programme d’orientation du jour même en Ontario et croient que des méthodes plus efficaces de CU devraient être facilement accessibles. Les personnes interrogées ont discuté des obstacles actuels à l’utiisation du DIU utilisé comme CU, incluant les coûts initiaux associés à l’insertion, et le manque général de connaissances sur la CU parmi les professionnels de la santé et les communautés. Discussion : Il existe un besoin important de formations professionnelles continues pour les pharmacien(ne)s sur la gamme complète de CU. Plusieurs démontrent un enthousiasme considérable quant au déploiement d’efforts pour améliorer l’accès à des méthodes plus efficaces de CU. Il semble justifié d’instaurer un projet pilote qui faciliterait l’orientation pour la pose postcoïtale d’un DIU, et ce, en temps opportun.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.006 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".