Current dispensing and practice use patterns of ulipristal acetate 30mg (Ella), as emergency contraception in British Columbia, Canada
Awarded 2019
Complex Family Planning Fellowship Research
Michelle Chan, MD
The University of British Columbia

Background: Ulipristal acetate 30 mg (UPA) became available as a Schedule 1 prescription-only emergency contraception (EC) in British Columbia, Canada in September 2015. UPA has been found to be superior in overweight women relative to levonorgestrel (LNG). Canadian data on UPA use is lacking.
Objectives: This will be the first study of current EC use and the impact of UPA in British Columbia. We hypothesize that Ella, the more effective oral emergency contraception option is underutilized relative to Levonorgestrel (LNG) in British Columbia.
 We aim to describe the current dispensing patterns of UPA compared to LNG as EC since UPA has become available in British Columbia. We will also explore the facilitators and barriers for physicians, pharmacists, and patients to UPA use.
Methods: This is a mixed-methods study which will include quantitative and qualitative approaches. For the quantitative component, we will include two data sources: (a) IMS Brogan, a privately held market research and consulting firm serving the Canada healthcare market that provides sales numbers of LNG and UPA between 09/2015 and 12/2018 and (b) PharmaNet, a provincial pharmaceutical database for British Columbia that includes more detailed patient and prescriber information of patients who filled a UPA prescription. Variables from PharmaNet will include deidentified: patient age, practice type, specialist flag and description, date of prescription service, postal code (patient, pharmacy, prescriber), census metropolitan area. Sales and prescription dispensation will serve as a proxy for “use” of UPA.
Qualitative data outcomes explore individual and organizational barriers and facilitators for prescribers, pharmacists and patients that affect UPA access in British Columbia. We will use Michie’s Theoretical Domains Framework to explore constructs of behaviour change theories. The framework explores implementation problems and informs potential interventions to enhance access.
Results: We anticipate that our results can inform and facilitate enhanced access to UPA. Data will be disseminated through presentations, peer-reviewed publications and study participants will receive a summary of findings if they so choose.