An analysis of the day and time of orders for EHC through an online triage

22nd June 2023 by Claire Taylor

Sara Day2, Sophie Jones2, Emma Ostridge3, Efejiro Ashano1, Vanessa Apea1,
1Preventx, 2Chelsea and Westminster Hospitals NHS Foundation Trust, 3Lloyds Pharmacy Online Doctor

Background

Unintended pregnancy remains a major public health concern in the United Kingdom. Young people and those of Black ethnicity have higher rates of abortion. Online contraception services offer an important pathway of access to emergency hormonal contraception (EHC). Understanding the patterns of service usage enables the tailoring of services to optimise access equity and identify key opportunities for patient engagement. We describe the demographics of users of a contraception e-service spanning 16 London boroughs and the timing of their ordering in 2022.

Methods

We conducted a retrospective analysis of anonymised data from a London contraceptive e-service between January 2022 and December 2022. The cohort of users was stratified by age, ethnicity, indices of multiple deprivation (IMD) and time of ordering EHC

Results

19171 orders of EHC were made with the majority (47.5%) by those aged 25–34. Those of Caribbean ethnicity were the most likely to order EHC (25.9%), followed by with a White British background and then those of African ethnicity; 23.2% and 17.9%, respectively. 53% of users were from the lowest 3 IMDs. 80% of women placed orders for EHC between 8AM and 11PM. Users were most likely to request on a Monday from 7am and least likely to do so on a Saturday.

Discussion

A London contraceptive e-service was accessible and predominantly used by those groups at higher risk of unintended pregnancy. Users were mostly under 35, of Caribbean or African descent and from more deprived areas of residence. Requests were made most frequently from early Monday morning. EHC provision offers opportunities to reduce abortion need and support transition to longer acting methods. Further mixed-method research is required to build on this insight. Exploring the perceptions of both users and potential non-users (e.g. low digital literacy, language barriers) will enable the design of services that truly maximise access to EHC.