Bigbee Jeri L, Abood Richard, Landau Sharon Cohen, Maderas Nicole Monastersky, Foster Diana Greene, Ravnan Susan
Department of Nursing, Boise State University, Boise, Idaho 83725-1840, USA.
J Rural Health. 2007 Autumn;23(4):294-8. doi: 10.1111/j.1748-0361.2007.00106.x.
Timely access to emergency contraception (EC) has emerged as a major public health effort in the prevention of unintended pregnancies. The recent FDA decision to allow over-the-counter availability of emergency contraception for adult women presents important rural health implications. American women, especially those living in rural and frontier areas, have one of the highest rates of unintended and teen pregnancy among developed countries.
This study, conducted prior to the recent FDA ruling, evaluated the participation among California pharmacies in the pharmacy access program in December 2005, specifically comparing rural/frontier and urban pharmacies.
The sample consisted of 862 California pharmacies, including 50 in rural/frontier areas, which were randomly selected and surveyed by telephone.
The results indicated that similar proportions of rural/frontier pharmacies and urban pharmacies provided direct pharmacy access services (28% vs 22%, P = 0.32). However, of the 13 rural/frontier counties included in the survey, eight (62%) had no emergency contraception pharmacies. The rural/frontier pharmacies that provided emergency contraception services tended to be small, independent pharmacies in the most remote areas of the state. Among rural/frontier pharmacies that did not participate in the program, the primary reasons included lack of training or demand for emergency contraception. Only one rural/frontier pharmacist cited moral or religious opposition to providing emergency contraception.
In light of the current limited over-the-counter status of emergency contraception, the role of rural and frontier pharmacies in ensuring access to emergency contraception will increase in the future.
及时获得紧急避孕措施已成为预防意外怀孕的一项重大公共卫生举措。美国食品药品监督管理局（FDA）最近决定允许成年女性非处方获取紧急避孕措施，这对农村卫生有着重要影响。在发达国家中，美国女性，尤其是那些生活在农村和偏远地区的女性，意外怀孕和青少年怀孕的比例位居前列。
本研究在FDA最近的裁决之前进行，评估了2005年12月加利福尼亚州各药房参与药房获取项目的情况，特别比较了农村/偏远地区药房和城市药房。
样本包括862家加利福尼亚州的药房，其中50家位于农村/偏远地区，这些药房是随机选取并通过电话进行调查的。
结果表明，农村/偏远地区药房和城市药房提供直接药房获取服务的比例相似（28%对22%，P = 0.32）。然而，在调查涵盖的13个农村/偏远县中，有8个县（62%）没有提供紧急避孕措施的药房。提供紧急避孕措施服务的农村/偏远地区药房往往是该州最偏远地区的小型独立药房。在未参与该项目的农村/偏远地区药房中，主要原因包括缺乏培训或对紧急避孕措施的需求不足。只有一名农村/偏远地区的药剂师提到出于道德或宗教原因反对提供紧急避孕措施。
鉴于目前紧急避孕措施非处方状态有限，农村和偏远地区药房在确保紧急避孕措施可及性方面的作用在未来将会增强。
