Women's perceptions of pharmacist‐prescribed hormonal contraception

Abstract

Introduction Unintended pregnancy is a public health issue, with young women in their late teens and early 20s at highest risk. Multiple approaches to increasing contraception access have been implemented, including adoption of statewide pharmacist prescribing legislation in multiple states. Indiana does not currently have such legislation in place. The objective of this study was to identify how women at risk for unintended pregnancy in central Indiana perceive pharmacist prescribing of contraception. Study Design Qualitative, one‐on‐one semi‐structured interviews. Methods Purposive, convenience sampling of eligible women 18 to 29‐years‐old who live in Indiana was used. Recruitment occurred via printed flyers placed in public locations that were not focused on health care, free classified online advertisements, and electronic flyers within Facebook social groups relevant to the study population. Interviews were conducted via telephone until thematic saturation was achieved. Participant demographics, baseline characteristics, current and past barriers to obtaining contraception, and perception of a pharmacist contraception prescribing model were collected. Interview transcripts were coded in an iterative manner with qualitative data analysis software (MAXQDA, Version 12) until consensus was achieved. Results Fourteen women completed the study. Four primary themes emerged encompassing accessibility, communication, pharmacist attributes, and payment. Thirteen participants would personally utilize a pharmacist prescribing contraceptive service and all stated that this service would be beneficial for other women. Of those women expressing a preference (n = 7), a female pharmacist would be preferred for service delivery. Participants expressed concerns related to access by minors, skills and training of the pharmacist, and environment within the pharmacy. Conclusions Women in Indiana desire broader access to contraception. Efforts should be made at the individual pharmacist‐provider level and statewide to explore strategies to increase access. Resources should be allocated to the creation of protocols for pharmacist prescribing within Indiana and other states.

Adolescents’ Perceptions of Contraception Access through Pharmacies

“…Specifically related to pharmacist contraceptive prescribing, young people expressed concerns related to confidentiality and privacy in the standard community pharmacy environment. These results are consistent with studies assessing perceptions of pharmacist prescribing in women of other ages [3,10]. The detailed qualitative data obtained through our study can be used to address any particular concerns young women may have with obtaining contraception directly from a pharmacist, to ensure that pharmacist prescribing processes are inclusive for women of all ages.…”

“…Limitations of this study include a sample of participants from one geographical region that is generally considered conservative and where pharmacy contraception prescribing is not currently available. However, because our results are similar to previously published studies in other geographic areas, we believe they signal common themes that can be used in wider implementation efforts [3,6,9,10]. Financial concerns for adolescents and state-specific laws regarding consent may be important barriers to consider, but were not addressed in our study design.…”

“…A common perception from our results, and those previously published, include a lack of awareness or understanding of the training pharmacists receive that enable them to provide a service such as contraceptive prescribing [10]. In addition to the training received during their education, states that currently allow pharmacist contraception prescribing have mandated an additional contraceptive-focused educational update prior to offering services [22].…”

“…While there are adult data evaluating the acceptability of pharmacist-prescribed contraception, less is known about acceptability and uptake of pharmacist prescribing among adolescents. The majority of adult women aged 18-44 years would utilize pharmacist prescribing if it was provided [3,10]. Of the women who were not currently using a form of contraception, 41% indicated that they would be likely to utilize pharmacist prescribing to obtain contraception, if available [3].…”

“…While a vast majority of women are healthy and have no medical contraindications for hormonal contraception, research with adult women who have chronic medical conditions or who take multiple daily medications shows more expressed concerns related to pharmacist prescribing of contraception compared to those without a chronic medical condition [10]. Approximately 20-25% of children and adolescents experience some type of chronic illness [12].…”