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A randomised controlled trial to determine the effectiveness of bridging from emergency to regular contraception: The Bridge –it study

What is BRIDGE-IT?

Emergency contraception (EC) is a tablet that can prevent pregnancy for women following unprotected sex or burst condoms etc. Most women who use EC in the UK go to a pharmacy for it. It is really important that women start a regular method of contraception after EC if they don’t want to become pregnant. However, most pharmacies cannot usually provide contraception (except condoms) without a prescription. This means that to start regular contraception (e.g. implant, pill etc) women must go to a GP or family planning clinic. Getting an appointment can take time and some women fall pregnant during this time. We are planning a research study called the ‘Bridge -it’ study. This study is designed to tell us whether or not pharmacists should be able to give a temporary supply (3 months) of the progestogen only pill (sometimes called ‘POP’) along with EC to women. The idea behind this study is that by giving women a supply of the POP they will have temporary contraception until they can go to a clinic to get their preferred method of contraception.

We call this ‘bridging contraception’ since it bridges the gap between getting EC and regular contraception. The POP is very safe with no serious risks. We have previously undertaken a smaller version of a similar study that showed that women who got one month of POP with EC were likely to use the POP and more likely to be using a regular method of contraception 6 weeks later. We had positive feedback from women, doctors, nurses and pharmacists about that study and have designed this new study based on this. We plan to do this study in several parts of the UK so that we can include women from a range of different backgrounds. Women aged 16 and over who attend a participating pharmacy for EC will be invited to take part in the study.

The study is designed as a randomised ‘crossover study’ this means that during the study, some pharmacies will give EC as usual, but others will give both EC and POP. After a few months, the treatments given at the pharmacies will switch, so that pharmacies that gave EC only will then switch to both EC and POP and vice versa. In this way, we can increase the chance of getting good quality results and can conduct the study more quickly. Women in the study will be surveyed by text/phone/email at 4 months. We will ask them about methods of contraception they have been using and where they got it from, if they used EC again and about any pregnancies they may have had.

For women who got the POP we will also ask if they used it, and if they attended the local family planning clinic for contraception. It is really important to obtain as accurate results as possible. Since we would like to know whether providing the POP with EC prevents unintended pregnancies for women, we will check how many women in the study had an abortion within one year of participation. This involves checking existing NHS databases with participants NHS numbers (individual health number that everyone has) and we would ask women's permission to do this. We would also check to see if women attended the local family planning or their GP for contraception. If we find a difference in contraceptive use or numbers of unintended pregnancies amongst women who got the POP, then we would calculate the costs or savings of this to the NHS. During the study we will also interview women and pharmacists about how providing the POP from the pharmacy might work in everyday practice. We will keep the public informed of all results.

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Key facts about the study and documents

What is this study about?

BRIDGE -IT is a cluster randomised controlled trial that involves 31 pharmacies in 3 UK regions London (South and Central), Lothian (Edinburgh and region) and Tayside (Dundee and region).

BRIDGE -IT will recruit a total of 626-737 women presenting for oral emergency contraception at study pharmacies.

BRIDGE –IT will compare standard care with emergency contraception against an intervention which is 3 months of a progestogen only pill and the offer to attend a local participating specialist contraceptive service to discuss and provide ongoing effective contraception.

BRIDGE –IT will determine if the intervention can reduce the number of unintended pregnancies for women seeking emergency contraception.

Women in both arms of the study will be contacted by telephone 4 months later for a short telephone interview to determine contraceptive use. The number of unintended pregnancies in both arms of the study, over the 12 months will be compared. The cost of providing the intervention will also be calculated.

BRIDGE –IT will also conduct interviews with pharmacists and some women to determine views on whether and how the intervention might become a part of routine clinical care.

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BRIDGE-IT has been funded by the National Institute for Health Research. For more information please visit