Rodriguez Maria I, McConnell K John, Swartz Jonas, Edelman Alison B
J Am Pharm Assoc (2003). 2016 Sep-Oct;56(5):521-6. doi: 10.1016/j.japh.2016.05.003.
Oregon has implemented legislation expanding the scope of pharmacists to directly prescribe short-acting hormonal contraception (pill and patch) without a medical prescription. Pharmacists are crucial to the success of the new law, but relatively little is known about their intentions to prescribe contraception, or the motivators or barriers in providing this service.
With the use of a cross-sectional survey of pharmacists practicing in Oregon before the legislative implementation, we analyzed responses to assess contraceptive knowledge, motivation to participate in direct provision, and perception of barriers to pharmacist prescription of contraception. A logistic regression model was used to examine the association between years in pharmacy practice and intention to provide direct access to contraception.
A total of 509 pharmacists responded (17%). If training and reimbursement were offered, more than one-half of pharmacists would potentially be interested in prescribing contraception, managing side-effects, or moving women to a different hormonal method (57%, 61%, and 54%, respectively). However, only 39.1% of pharmacists surveyed planned to actually prescribe hormonal contraception when the legislation took effect. Shortage of pharmacy staff to provide services, concerns about liability, and a need for additional training were the three largest barriers to participation. Pharmacists practicing in urban locations (odds ratio 1.73, 95% CI 1.11-2.70) or currently offering emergency contraception (odds ratio 2.23, 95% CI 1.47-3.40) were significantly more likely to be planning to participate.
Preliminary data indicate a need to support pharmacists with education on contraceptive provision and development of interventions to facilitate counseling in the pharmacy setting.
俄勒冈州已实施相关立法,扩大药剂师的职责范围,允许其在无医生处方的情况下直接开具短效激素避孕药(药片和贴片)。药剂师对于这项新法律的成功实施至关重要,但对于他们开具避孕药的意愿、提供此项服务的动机或障碍,我们了解得相对较少。
在立法实施前,我们对俄勒冈州执业药剂师进行了横断面调查,分析他们的回复以评估避孕知识、参与直接提供服务的动机以及对药剂师开具避孕药的障碍认知。采用逻辑回归模型来检验药剂师从业年限与提供直接避孕服务意愿之间的关联。
共有509名药剂师回复(回复率17%)。如果提供培训和报销,超过一半的药剂师可能有兴趣开具避孕药、处理副作用或为女性更换不同的激素避孕方法(分别为57%、61%和54%)。然而,在接受调查的药剂师中,只有39.1%计划在立法生效后实际开具激素避孕药。药房工作人员短缺以提供服务、对责任的担忧以及需要额外培训是参与这项服务的三大障碍。在城市地区执业的药剂师(优势比1.73,95%可信区间1.11 - 2.70)或目前提供紧急避孕服务的药剂师(优势比2.23,95%可信区间1.47 - 3.40)更有可能计划参与此项服务。
初步数据表明,有必要为药剂师提供关于避孕服务的教育,并制定干预措施以促进药房环境中的咨询服务。