Serbian gynecologists' and pharmacists' beliefs about emergency contraception

Emergency contraception (EC) in Serbia is available in two products: Levonorgestel, which has nonprescription status, and Ulipristal acetate, which is a prescription-only medicine. Considering their dispensing statuses, gynecologists and pharmacists are health care professionals (HCPs) with the widest impact on EC use. Yet little is known about their beliefs and practices regarding these medicines. We surveyed 166 gynecologists (during October 2012-October 2013) and 452 community pharmacists (during January-April 2014). Results showed significant differences between these two groups, suggesting that provision of EC to users may be inconsistent. Gynecologists were more convinced than pharmacists that EC would reduce the abortion rate (86% versus 53%, p <.001). However, they were more concerned than pharmacists that easy access to EC would cause less regular contraceptive use (66% versus 29%, p <.001) and risky sexual behaviors, including initiating sexual activity at a younger age (37% versus 19%, p <.001) and having more sexual partners (33% versus 12%, p <.001). Additionally, more pharmacists than gynecologists (12% versus 2%, p <.001) said they would not provide EC to anyone under any circumstance, even to victims of sexual assault. These results indicated a need for reevaluating and establishing official guidelines for dispensing practices.