The ALLIANCE Trial 

Access to high-quality accurate contraceptive counselling and methods have the potential to reduce unintended pregnancy and abortion rates. Community pharmacists could play an expanded role in contraceptive counselling and referral to contraceptive prescribers particularly when community pharmacists are consistently seen by consumers as a trusted and valued part of the healthcare system.

The ALLIANCE Trial proposes that expanding pharmacists’ scope of practice, while simultaneously addressing known barriers to expanding this scope, could improve women’s use of effective contraception and reduce the rate of subsequent unintended pregnancies among women presenting to pharmacies for ECP or EMA.

Therefore, the ALLIANCE Trial aims to compare the subsequent uptake of effective contraception (hormonal or intrauterine) in women seeking emergency contraceptive pill or medical abortion medicines, who receive the ALLIANCE community pharmacy-based intervention with those who do not receive the intervention.

This is a stepped-wedge pragmatic cluster randomised trial in community pharmacies across two Australian states – New South Wales and Victoria. The ALLIANCE intervention involves community pharmacists delivering structured, patient-centred, effectiveness-based contraceptive counselling (and a referral to a contraceptive prescriber where appropriate) to women seeking either emergency contraceptive pills or to have medical abortion medicines dispensed.

The implementation and delivery of the ALLIANCE intervention is supported through a “bundle” of proven methods:

• an online educational module developed in partnership with Pharmaceutical Society of Australia;
• a 1-hour academic detailing session with a facilitator to discuss how to implement the intervention; and
• participation in a virtual community of practice (CoP) – AusCAPPS Network.

Codesign methods were used in developing the intervention and implementation support, we anticipate that the intervention will have both immediate and sustainable impact across metropolitan, regional and rural regions.

The ALLIANCE Trial is anticipated to provide new evidence to inform health system improvement globally by broadening the scope of practice of community pharmacists in the provision of sexual and reproductive health services in primary care—alongside addressing the Australian senate inquiry’s recommendation.

This Project is supported by the Medical Research Future Fund