Pharmacist interest in and attitudes toward direct pharmacy access to hormonal contraception in the United States
Sharon Landau A1, Kathleen Besinque A2, Frances Chung A3, Ingrid Dries-Daffner A4, Nicole Monastersky Maderas A5, Belle Taylor McGhee A6, Diana Greene Foster A7
A1 Pacific Institute for Women's Health, Los Angeles, CA
A2 University of Southern California, Los Angeles
A3 Northern California Region, Oakland
A4 Berkeley Media Studies Group, Berkeley, CA
A5 Pharmacy Access Partnership, Oakland, CA
A6 Pacific Institute for Women's Health, Oakland, CA
A7 Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco
Abstract: Objectives: To assess pharmacist interest, comfort level, and perceived barriers regarding providing pharmacist-initiated access to hormonal contraceptives (i.e., tablets, patches, rings, injectables, emergency contraception [EC]). Design: Descriptive, nonexperimental, cross-sectional study. Setting: United States between November 2004 and January 2005. Participants: 2,725 pharmacists working in community chain pharmacies (64%), community independent pharmacy (31%), and other practice settings, including hospitals and home care facilities (5%). Intervention: Survey sent electronically by the American Pharmacists Association to a random sample of 14,142 of its 50,000 pharmacist members nationally. Main outcome measures: Pharmacist interest and comfort level in providing pharmacy access to hormonal contraception (HC), perceived barriers and training needs, and familiarity with and provision of EC. Results: 2,725 survey responses (19% response rate) were received. Pharmacists reported being very familiar with HC. The majority of respondents were comfortable and interested in providing direct access to HC in the pharmacy. Perceived barriers to providing HC in the pharmacy included lack of time, no mechanism of reimbursement for the service, and possible resistance from physicians. Conclusion: Strong interest, comfort level, and capability from pharmacists, combined with a documented demand for direct pharmacy access from patients, indicate that pharmacy access to HC has the potential to meet patient needs and increase access to HC. Education about current clinical practice recommendations—which no longer require pelvic examinations and Papanicolaou (Pap) smears before hormonal contraception is initiated—may increase pharmacist support for providing hormonal methods directly.
Keywords:
Contraceptives, pharmacy-access drug products, surveys
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