Objective
Oregon has implemented legislation expanding the scope of pharmacists to directly prescribe short-acting hormonal contraception (pill and patch) without a medical prescription. Pharmacists are critical to the success of the new law, but relatively little is known about their intent to prescribe contraception, or the motivators or barriers in providing this service.
Methods
Cross-sectional survey of pharmacists practicing in Oregon prior to legislative implementation. We analyzed responses to assess contraceptive knowledge, motivation to participate in direct provision and perception of barriers to pharmacist prescription of contraception. A logistic regression model was used to examine the association between years in pharmacy practice and intent to provide direct access to contraception.
Results
509 pharmacists responded (17%). If training and reimbursement were offered, over half of pharmacists would potentially be interested in prescribing contraception, managing side effects or transitioning women to a different hormonal method (57%, 61% and 54% respectively). However, only 39.1% of pharmacists surveyed planned to actually prescribe hormonal contraception when the legislation took effect. Shortage of pharmacy staff to provide services, concerns about liability, and a need for additional training were the three largest barriers to participation. Pharmacists practicing in urban locations (OR 1.73 95%CI 1.11–2.70) or currently offering emergency contraception (OR 2.23 95%CI 1.47–3.40) were significantly more likely to be planning to participate.
Conclusion
Preliminary data indicate a need to support pharmacists with education on contraceptive provision and development of interventions to facilitate counseling in the pharmacy setting.