Extended Access to Hormonal Contraception in Pharmacies: A Survey among Swiss Pharmacists

Abstract

Background: Worldwide the availability to Hormonal Contraceptives (HC) varies from over the counter (OTC) to prescription-only access. In various countries pharmacists are allowed to prescribe HC, although conditions may be different. In Switzerland, HC require a prescription from a physician, although Swiss law allows pharmacists to dispense prescription-only medications in justified exceptional cases without a valid physician’s prescription. This study aimed to identify current dispensing practices for HC in Swiss pharmacies, pharmacists’ knowledge about HC, and their opinion and interest about expanding access to HC. Methods: Web-based survey among Swiss pharmacists. Results: This survey was completed by 397 registered pharmacists and 331 (83%) were included for analysis. The survey showed that 21% of respondents regularly dispense HC without prescription and that a high number of participants are either very interested (57%, n = 189) or rather interested (33%, n = 110) in extended pharmacy access to HC. The majority did not or rather not support physician’s prescription-only status (77%, n = 256) or OTC availability (94%, n = 310). Furthermore, surveyed pharmacists are willing to train for contraception services (90%, n = 299). According to participants, resistance of physicians is the most relevant barrier to this service (88%, n = 292). Conclusion: Surveyed pharmacists are interested in extended access to HC.

Physicians’ Opinion Regarding Extended Access to Hormonal Contraception in Switzerland

“…This finding can be explained due to the different safety profile of POP and is in line with recent research in the UK, where respondents were largely supportive of pharmacy-led provision of HC and initiation of POP was most strongly supported [22]. Our survey revealed a clear refusal of OTC access to HC, which corresponds to the view among pharmacists in Switzerland [19]. This attitude is also in agreement with the "conservative attitude" among German pharmacists to a possible OTC switch of HC in Germany, whereas patients and physicians were partly open to it, especially younger physicians (<50 years) [23].…”

“…We found physicians being concerned about unknowledgeable pharmacists and they doubt that pharmacists would have enough time for counseling on HC. In contrast to this, the majority of participating pharmacists in our previous survey were not concerned about the lack of time [ 19 ]. In addition, Parsons et al showed that trained community pharmacists provide appropriate contraception service and that pharmacies are reasonable sites to provide HC [ 10 ].…”

“…A specialized training should be required in order to provide appropriate and safe contraception service. Our previous study showed that participating pharmacists were highly interested in providing contraception services and motivated to complete a special training [ 19 ]. This might be explained by the fact, that we found a high proportion of pharmacists regularly challenged with situations where no valid prescription for HC is available and have to help out on a timely basis.…”

“…The survey was provided in German and French. Items of interest are based on our previous research among pharmacists [ 19 ] and few new items were developed for this survey among physicians and optimized in a multiple-stage process. The questionnaire was tested in pilot trials.…”

“…Under this new law, prescription-only drugs will be revised and pharmacists providing access to HC could be a new strategy to facilitate access to birth control. In 2020, a survey was conducted among pharmacists in Switzerland in order to gain insight regarding their opinion and interest in extended access to HC [ 19 ]. However, no data are available for physicians in Switzerland.…”