Do community pharmacies unnecessarily recommend oral emergency contraception? A nationwide mystery caller investigation in Germany

Background

Since 2015, oral emergency contraceptives (ECs) have been available in German community pharmacies without prescription as over-the-counter medicines. Given the financial burden, unnecessary hormonal exposure and associated side effects, systematic information gathering is crucial to prevent unnecessary recommendations. This study aimed to determine whether pharmacy staff ask the checklist questions recommended by the German Federal Chamber of Pharmacists (BAK) guideline and provide correct recommendations when oral EC is not indicated (appropriate outcome), and to examine associated factors.