NOT suitable for:
- clients under 16
- those not proficient in the English language.

FSRH now state that, whilst rare, anaphylactic reaction is possible with both first and subsequent exposures to Sayana Press. It is therefore recommended that users are advised to ensure there is a competent adult present at the time of self administration who is aware that they should call for emergency help at the time of onset of any relevant symptoms.
Consultation 1:

A) The clinician should give or supervise the first injection while instructing the patient on its use.

B) If patient is keen to use Sayana Press, give Sayana information booklet. Give patient the video training link so that they can familiarise themselves with it.

C) Send the link to them using NaSH SMS messenger and/or give them the DVD to take home.

Consultation 2:

D) Show the patient the training video and check if they have any questions or concerns.

E) Patient self-administers Sayana Press under nurse supervision. If the patient wishes to continue with Sayana Press a prescription for three further doses can be dispensed.

F) Give patient a
- card on setting up text reminders,
- sharps bin and verbal instructions on use,
- date for annual review (20 mins booked appointment).
Sharps canisters should be locked and returned to Sandyford Services.

G) Set up recall on SC Sayana VD for the next 3 injections every 13 weeks to ensure that the patient self administers their next 3 injections.

H) Ask patient to set up an SMS text reminder on her mobile from Sayana Press. This involves texting SELF to 83311 with the date of her last injection (e.g., SELF 27.01 for an injection on 27th January 2016). Give her the link for setting up SMS reminders.

Consultation 3:

I) Annual review. This can be virtual or face to face. Patient can self administer Sayana Press under observation. A Sayana Press prescription can be dispensed for the next three doses if it is clear the patient is happy with the method and not wishing a pregnancy in the next year.

J) Replace sharps box.

K) Set up reminders as Consultation 2.

L) Make appointment for next annual review.