Pharmacist Outlooks on Prescribing Hormonal Contraception Following Statewide Scope of Practice Expansion

Abstract

In an effort to increase access to contraception, the pharmacist scope of practice is being expanded to allow prescribing. While this is being accomplished in the United States by a variety of models, legislation that allows pharmacists to prescribe hormonal contraception under a statewide protocol is the most common. This study was designed to explore the outlooks of pharmacists regarding prescribing contraception in the period following the first state legislation and prior to statewide protocol development and availability. A qualitative study of community pharmacists in California using structured phone interviews explored their opinions regarding access to contraception in pharmacies and outlooks regarding prescribing. Data were analyzed using an inductive approach to identify themes. Among the thirty participants, the majority worked in a chain pharmacy. Themes were identified in five overarching domains: Pharmacist barriers, system barriers, patient issues, safety concerns, and pharmacist role. Most were unfamiliar with the new law, yet were interested in expanding access for patient benefit despite foreseeing challenges with implementing the service in community pharmacies. Barriers will need to be addressed and requisite training disseminated widely to facilitate successful implementation and thus improve access on a broad scale. Further research following protocol implementation is needed to understand service implementation, as well as patient utilization and satisfaction.

Attitudes of Michigan Female College Students about Pharmacists Prescribing Birth Control in a Community Pharmacy

“…The predominant concerns the students had were not getting regular Pap smears and screenings and potentially being prescribed the wrong birth control. These advantages and concerns are similar to other studies [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Many women do not know that a Pap smear and breast exam are not required for birth control use [ 2 ].…”

“…Pharmacist trustworthiness, approachability, and visit expenses significantly influenced their likelihood of using birth control pharmacists. In the opinion-based studies about pharmacist prescribing, women of all ages would use or support this service, but they do express concerns as well [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. Our research adds that prior use of pharmacy services and perceptions of pharmacist attributes influence these opinions.…”

“…Data have documented adolescents [ 18 , 19 , 20 ], women [ 18 , 20 , 21 ], pharmacists [ 22 ], student pharmacists [ 23 ] and primary health care providers [ 24 ] support of pharmacists prescribing birth control. More information is needed to identify which teens and women will use pharmacists for their birth control access.…”

“…More information is needed to identify which teens and women will use pharmacists for their birth control access. In California, 90% of pharmacists agreed with community pharmacists prescribing birth control, and 63% stated willingness to add this service to their practice [ 22 ]. Seventy-six percent of reproductive health physicians and 70% of midlevel practitioners supported pharmacists prescribing birth control, higher approvals than behind the counter and over-the-counter birth control access [ 24 ].…”

Implementation of hormonal contraceptive furnishing in San Francisco community pharmacies

“…11 Additional barriers reported include concerns about liability, time constraints, and lack of knowledge of this service. [12][13][14] As a result, although pharmacists have expressed interest in expanding their roles when surveyed, few have actually done so. 15 There is limited research identifying what differentiates pharmacies that effectively implement contraceptive furnishing, and the effects of existing policy on contraceptive continuation.…”