Increasing Access to Emergency Contraception through Community Pharmacies: Lessons from Washington State

Gardner, Jacqueline S.; Hutchings, Jane; Fuller, Timothy S.; Downing, Don

doi:10.2307/2673721

Cited by 48 publications

(31 citation statements)

References 9 publications

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“…2 Even though it has been announced by the U.S. Food and Drug Administration (FDA) as safe and effective since 1997, 4 ECP remains an underused method of pregnancy prevention. 5 To increase availability of ECP, prior studies have examined several dispensing options, including direct access through pharmacists, [6][7][8] provision of a prescription by providers in advance of need (i.e., advance provision), [9][10][11][12][13] and direct access to ECP without a prescription by making it available over-the-counter (OTC). 14,15 The studies provide evidence that these dispensing options are effective in increasing the use of ECP.…”

Section: Introduction Ementioning

confidence: 99%

Emergency Contraception Provision: A Survey of Michigan Physicians from Five Medical Specialties

Vahratian

Patel

et al. 2007

Journal of Women's Health

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Objective: Despite the controversy over expanding delivery options for emergency contraceptive pills (ECP), little is known about physicians' attitudes toward over-the-counter (OTC) provision of ECP, and prior research on physicians' practices often has focused on a single specialty. This study examined the attitudes and practices regarding advance provision and OTC status of ECP among physicians in five medical specialties likely to encounter patients in need of ECP.Methods: A mail survey of a random sample of 850 Michigan physicians in family/general medicine, internal medicine, obstetrics/gynecology, pediatrics, and emergency medicine was conducted. Respondents' ECP-related attitudes and practices were assessed, and differences by physician characteristics were examined using chi-square tests and multivariable logistic regression analyses.Results: Two hundred seventy-one physicians responded to the survey (response rate ‫؍‬ 32%), with 42% of them favoring OTC provision of ECP and 40% opposing it. Half of respondents never routinely initiated discussions about ECP with their sexually active, female patients, and 77% of respondents did not routinely offer advance prescriptions. After adjusting for other factors, including medical specialty, older physicians (Ն50 years) were significantly more likely than their younger counterparts to support OTC provision of ECP (OR ‫؍‬ 2.9, 95% CI 1.7-4.9) or offer advance prescriptions (OR ‫؍‬ 2.5, 95% CI 1.1-5.8). Physicians with a specialty in obstetrics/gynecology were 3.5 times (95% CI 1.3-9.8) as likely as physicians in family/general medicine to offer advance prescriptions for ECP, and female physicians were 2.5 (95% CI 1.05-6.0) times as likely as male physicians to offer advance prescriptions. Graduation from a medical school within the United States and practicing in a private practice were marginally associated with a lower likelihood of supporting OTC status of ECP (OR ‫؍‬ 0.5, 95% CI: 0.2-1.0; and OR ‫؍‬ 0.6, 95% CI 0.3-1.1, respectively).Conclusions: Certain physician characteristics were significantly associated with their ECPrelated attitudes and practices. The majority of physicians surveyed in this study did not offer advance prescriptions for ECP, and few had initiated discussions on ECP with patients, which may pose critical barriers to patients' timely access. 489

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Section: Introduction Ementioning

confidence: 99%

Emergency Contraception Provision: A Survey of Michigan Physicians from Five Medical Specialties

Vahratian

Patel

et al. 2007

Journal of Women's Health

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“…Education about EC for both physicians and the public should be improved, especially now that other agents (including RU-486 [mifepristone]) have been shown to be effective in preventing unwanted pregnancy after an episode of unprotected intercourse. 4 Importantly, physicians may wish to reconsider their position on EC in relation to other contraceptive methods; as this study suggests, regular contraception and EC are not in conflict. Sexually active women who do not desire to become pregnant should be counseled about regular methods of birth control, but they can be assured that EC is available if they are concerned their regular method may not have protected them from the possibility of an unwanted pregnancy.…”

Section: Placing Emergency Contraception In the Hands Of Womenmentioning

confidence: 99%

“…Indeed, studies have demonstrated that the rate of EC use is doubled when it is provided in advance of need. 3 In the United States, 6 states (Washington and Maine, with pilot programs in Alaska, California, New Mexico, and Hawaii) have legislatively sanctioned pharmacy access to EC without needing a physician's prescription, 4,5 but the effects of this availability on clinical outcomes and rates of use have not yet been evaluated.…”

Section: Placing Emergency Contraception In the Hands Of Womenmentioning

confidence: 99%

Placing Emergency Contraception in the Hands of Women

Litt¹

2005

JAMA

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“…299 If the facility is not willing to provide EC or write the needed prescriptions, it is recommended that the patient be given local referrals to medical facilities that can immediately assist with alternative treatment.…”

Section: Pregnancy Risk Evaluation and Carementioning

confidence: 99%

Office on Violence Against Women

Onieal¹

2006

Encyclopedia of Sexual Behavior and the Law

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AcknowledgmentsMany individuals contributed their skills and expertise to the development of this protocol. Special appreciation goes to Kristin Littel, who served as the primary writer and researcher for the protocol. We would also like to thank the Office for Victims of Crime for initiating this project and for providing feedback and guidance throughout the drafting process. We are grateful to all of the women and men who gave their time and energy to attend the focus groups, participate in the conference calls, and review numerous drafts of the protocol; their efforts greatly enhanced the final product. We are particularly grateful for the assistance of Gail Burns Smith who, in addition to participating in focus groups and conference calls and submitting insightful comments on drafts, also was responsible for suggesting and organizing conference calls with victims to ensure the victim-centeredness of the protocol.ii iii

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Increasing Access to Emergency Contraception through Community Pharmacies: Lessons from Washington State

Cited by 48 publications

References 9 publications

Emergency Contraception Provision: A Survey of Michigan Physicians from Five Medical Specialties

Emergency Contraception Provision: A Survey of Michigan Physicians from Five Medical Specialties

Placing Emergency Contraception in the Hands of Women

Office on Violence Against Women

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