The acceptability of remote prescribing and postal delivery services for contraceptive pills and treatment of uncomplicated Chlamydia trachomatis

Abstract

Objectives: The digitalisation of sexual and reproductive health (SRH) services offer valuable opportunities to deliver contraceptive pills and Chlamydia treatment by post. We aimed to examine the acceptability of remote prescribing and “medication-by-post” in SRH.

Study design: An online survey assessing attitudes towards remote management was distributed in three UK SRH clinics and via an integrated sexually transmitted infection (STI) postal self-sampling service. Logistic regressions were performed to identify potential correlates. 

Results: There were 1281 participants (74% female and 49% <25 years old). Eight per cent reported having received medication via post and 83% were willing to receive Chlamydia treatment and contraceptive pills by post. Lower acceptability was observed among participants who were: >45 years old OR:0.43(0.23-0.81), screened for STIs less than once annually OR:0.63(0.42-0.93), concerned about confidentiality OR:0.21(0.90-0.50), concerned about absence during delivery OR:0.09(0.02-0.32), unwilling to provide blood pressure readings OR:0.22(0.04-0.97). Higher acceptability was observed among participants who reported: previously receiving medication by post OR:4.63(1.44-14.8), preference for home delivery over clinic collection OR:24.1(11.1-51.9), preference for home STI testing OR:10.3(6.16-17.4), ability to communicate with health advisors OR:4.01(1.03-15.6), and willingness to: register their real name OR:3.09(1.43-10.6), complete online health questionnaires OR:3.09(1.43-10.6), and use generic contraceptive pills OR:2.88(1.21-6.83).

Conclusion: Postal treatment and entering information online to allow remote prescribing were acceptable methods for SRH services and should be considered alongside medication collection in pharmacies. These methods could be particularly useful for patients facing barriers in accessing SRH. The cost-effectiveness and implementation of these novel methods of service delivery should be further investigated. 

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