Optimization of the counseling on emergency contraception using ‘audit-feedback’ and ‘serious gaming’ implementation strategies

Hormonal emergency contraception is commonly used, as shown by the large number of packages that are dispensed annually in Belgian community pharmacies. From a societal perspective, it is essential that emergency contraception is used correctly and with the necessary professional guidance. As the emergency contraceptive pill (ECP) can be dispensed and reimbursed ‘over-the-counter’, community pharmacists have a crucial role in ensuring its safe and rational use. Nevertheless, dispensing of ECP in community pharmacies does not (yet) always meet the desired quality standards. Pharmacists also find the different guidelines on ECP available in Belgium confusing. Recently, the evidence-based information on ECP was standardized and updated. In addition, a generic protocol for ECP dispensing was developed and pilot-tested which could serve as an additional tool to standardize ECP dispensing and to ensure the quality of care. The aim of this project is to implement the updated evidence-based information and dispensing protocol in practice. Therefore, two different implementation strategies will be used, i.e. an 'audit-feedback' approach using simulation patients and a 'serious game'. At the same time, the effectiveness of both strategies will be compared, and a process evaluation will be carried out. As emergency contraception is often considered a 'sensitive' topic by patients and healthcare providers making adequate communication with the patient essential, the provision of only information and tools is insufficient to guarantee the quality and uniformity of ECP dispensing. Optimal implementation can lead to better counseling on ECP, reduced unnecessary use of ECP, reduced risk of unwanted pregnancies, better use of contraception, improved collaboration between medical doctors and pharmacists and faster identification of and response to crisis situations.