Evaluation of Undergraduate Pharmacy Students’ Knowledge, Attitudes, and Practices Regarding Emergency Contraception

Abstract

Background: Emergency contraception (EC) is an important option for preventing unintended pregnancy after unprotected intercourse or contraceptive failure. Pharmacists play a key role in providing information on EC, dispensing it, and offering counselling. However, inadequate knowledge and unfavorable attitudes among future pharmacists may compromise the appropriate provision of EC services. Objectives: To assess knowledge, attitudes, practices, and perceived barriers regarding EC among undergraduate pharmacy students and identify factors associated with poor knowledge and negative attitudes. Methods: A cross-sectional survey was conducted among undergraduate pharmacy students using an adapted 34-item questionnaire. Data were analyzed using descriptive statistics and multivariable binary logistic regression. Knowledge and attitude outcomes were categorized using modified Bloom’s criteria. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, and P < 0.05 was considered statistically significant. Model diagnostics included assessment of multicollinearity, goodness of fit, and sparse categories. Results: Of 561 eligible students, 502 participated (89.5%). Poor EC knowledge was observed in 62.5% of participants, with major gaps in knowledge of the mechanism of action (14.1%), indications (22.9%), dosage (29.1%), and timing (31.3%). Negative attitudes were reported by 58.8%. Among female students, 14.4% had previously used emergency contraceptive pills (ECPs), and 20.8% had discussed EC with a partner. Key barriers included lack of knowledge (21.4%), religious or moral concerns (19.2%), and fear of side effects (17.8%). Poor EC knowledge was associated with religion (AOR = 1.68, 95% CI: 1.11 - 2.54) and study year, particularly the second year (AOR = 9.16, 95% CI: 4.23 - 19.80). Conclusions: Pharmacy students demonstrated substantial gaps in EC knowledge, negative attitudes, and limited EC-related practices. Early, structured EC education should be integrated into pharmacy curricula to strengthen their knowledge, counseling skills, and evidence-based practice.