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Objective: The emergency contraceptive pill (ECP) is a prescription-only drug in Barbados. Knowledge attitudes and practices with regards to ECPs are uncertain. Methods: Women aged 18-44 years attending three public sector polyclinics completed a questionnaire. Quota sampling was done in proportion to clinic size and age distribution of the Barbados population. Results: Of 378 respondents (response rate 91% median age 31 years) 86% were previously pregnant 17 22 47 and 15% had 0 1 2-3 and >/= 4 children respectively; 52% had used contraception at last intercourse 26% would be happy if they became pregnant 29% reported a termination of pregnancy 43% were aware that ECPs existed and could be used to prevent pregnancy after intercourse and 14% had used ECPs. Of the 162 women who knew ECPs existed 32% thought it needed to be used within one day. Women 36 to 44 years of age were less likely to have used ECPs than younger women (p = 0.03). Most users (66%) obtained the pill directly from a pharmacy without a prescription. After receiving information that the ECP exists 243 women (64%) would or might use it if necessary with 42% preferring to obtain it without a prescription from a pharmacy. Those concerned that ECPs caused abortions were less willing to use it compared to those who were not (30% vs 74% p < 0.001). Conclusions: Awareness and use of ECPs are low. Education on mode of action and time limit for use and non-prescription access are needed.

Aims To determine the prevalence and potential risk factors for diabetic peripheral neuropathy with a loss of protective sensation in Barbados. Methods A representative population sample aged > 25 years with previously diagnosed diabetes or a fasting blood glucose ≥ 7 mmol/l or HbA1c ≥ 48 mmol/mol (6.5%) was tested by 10 g monofilament at four plantar sites per foot and a 28 Hz tuning fork and neurothesiometer at the hallux. Data were adjusted to the age structure of people with diabetes in Barbados. Multivariable logistic regression assessed associations with peripheral neuropathy with a loss of protective sensation. Results Of 236 participants [74% response rate, 33% men, 91% black, median age 58.6 years, mean BMI 30.1 kg/m2, mean HbA1c 54 mmol/mol (7.1%)], 51% had previously diagnosed diabetes. Foot examination demonstrated that 25.8% (95% CI 20.2 to 31.5) had at least one insensate site with monofilament testing, 14.8% (95% CI 10.2 to 19.4) had an abnormal tuning fork test and 10.9% (95% CI 6.9 to 14.9) had a vibration perception threshold > 25 V. Peripheral neuropathy with a loss of protective sensation prevalence was 28.5% (95% CI 22.7 to 34.4) as indicated by monofilament with ≥ 1 insensate site and/or vibration perception threshold > 25 V. With previously diagnosed diabetes the prevalence was 36.4% (95% CI 27.7 to 45.2) with 98.4% of cases identified by monofilament testing. Increasing age, previously diagnosed diabetes, male sex and abdominal obesity were independently associated with peripheral neuropathy with a loss of protective sensation. Conclusions Over a third of people with previously diagnosed diabetes had evidence of peripheral neuropathy with a loss of protective sensation. Monofilament testing alone may be adequate to rule out peripheral neuropathy with a loss of protective sensation. Monofilament and neurothesiometer stimuli are reproducible but dependent on participant response., What's new? In Barbados, foot problems account for 89% of diabetes‐related hospital admissions, but in primary care only 41% had a foot examination over a 2‐year period. Peripheral neuropathy prevalence in a predominantly African descent Caribbean population with diabetes is unknown.In people with known and newly diagnosed diabetes, the prevalence of peripheral neuropathy with a loss of protective sensation was 28.5% (95% CI 22.7 to 34.4) as indicated by monofilament testing with ≥ 1 insensate site and/or vibration perception threshold > 25 V. Monofilament testing alone identified 98% of such cases in people with previously diagnosed diabetes.Monofilament testing alone may be adequate for screening for peripheral neuropathy with a loss of protective sensation.