A survey of sexually active women in the United States revealed that 29% experienced challenges in obtaining either a prescription or a refill for hormonal contraception. As medication experts and highly trusted professionals, pharmacists can help decrease patient barriers to adherence in the community-based pharmacy setting.

The journal Contraception has published a study showing that pharmacists in California and Oregon are serving as an access point for hormonal contraception services and supplies for diverse patient populations. The descriptive study included 391 community-based pharmacies in which a total of 2117 visits were completed over a 6-month period.

During this time, pharmacists who had completed standardized training wrote and dispensed 1970 hormonal contraceptive prescriptions. Of the 2117 visits, 93% of patients received hormonal contraception; the remaining 7% were referred to their PCPs, most commonly due to elevated blood pressure, which is a contraindication to receiving the medication.

Although health care insurance reimbursement was not available during the study, the Medicaid programs in each respective state implemented billing for pharmacy services shortly after. Patients paid an out-of-pocket flat service fee and pharmacists billed contraceptive services to the patient’s insurance. However, pharmacist reimbursement remains a nationwide barrier for implementing new pharmacy services.

The majority of prescriptions were issued to adults aged in their mid-twenties for a full year’s supply of either the combination or progestin-only contraception pill. In previous studies, women who received a 12-month supply of oral contraceptives showed increased adherence and a 30% reduction in unintended pregnancies in comparison to those who received a 1-month or 3-month supply.

With this in mind, expanding pharmacists’ scope of practice at the state level to include prescribing self-administered hormonal contraception may concurrently increase patient adherence and decrease unintended pregnancies.

Since closure of the study period, statewide protocols for pharmacist prescribing has grown to include Colorado, Hawaii, Maryland, and New Mexico.
 
Danielle McPherson is a 2019 PharmD Candidate at the University of Connecticut in Storrs, Connecticut.

Reference

Lu S, Rafie S, Hamper J, Strauss R, Kroon L. Characterizing pharmacist-prescribed hormonal contraception services and users in California and Oregon pharmacies. Contraception. 2018 Dec 16. pii: S0010-7824(18)30525-0. doi: 10.1016/j.contraception.2018.12.002. [Epub ahead of print]