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加利福尼亚州新立法授权后药剂师开具激素避孕药物的意向

Pharmacist Intentions to Prescribe Hormonal Contraception Following New Legislative Authority in California.

作者信息

Vu Kevin, Rafie Sally, Grindlay Kate, Gutierrez Hialy, Grossman Daniel

机构信息

1 Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA, USA.

2 Present Address: Department of Pharmacy, James J. Peters VA Medical Center, Bronx, NY, USA.

出版信息

J Pharm Pract. 2019 Feb;32(1):54-61. doi: 10.1177/0897190017737897. Epub 2017 Nov 2.

Abstract

OBJECTIVE

: Following a California law expanding pharmacists' scope of practice to include directly providing self-administered hormonal contraception to patients pursuant to a statewide protocol, this study aimed to assess California pharmacists' intentions to provide this new service prior to the protocol development and implementation.

DESIGN

: Descriptive, nonexperimental, cross-sectional study.

SETTING

: California between August and September 2014.

PARTICIPANTS

: California pharmacists working in community pharmacies.

INTERVENTION

: Invitations to participate in the online survey were sent to 1774 pharmacists.

MAIN OUTCOME MEASURES

: Main outcomes included pharmacists' current practices, intentions to prescribe hormonal contraception, comfort performing various activities, knowledge about contraceptive methods, training needs, and barriers to prescribing.

RESULTS

: A total of 257 responses (14.5% response rate) were received. Of those, 121 respondents met inclusion criteria and were included in the analysis. About half of the respondents (49.6%) reported working in a community chain pharmacy, 46.3% in an independent pharmacy, and 4.1% in other community pharmacy settings. The majority (72.7%) of pharmacists reported that they would likely provide this new service. Respondents reported being comfortable educating patients on short-acting (94.2%) and long-acting reversible contraception (81.7%), as well as identifying drug interactions with hormonal contraception (96.7%). Respondents indicated time constraints (74.4%), lack of reimbursement (63.6%), and liability concerns (62.0%) as barriers to prescribing hormonal contraception.

CONCLUSIONS

: California pharmacists expressed strong intentions and comfort in prescribing hormonal contraception. Pharmacists' additional training needs and barriers should be addressed for successful implementation. This new service has great potential to increase access to contraception, potentially fostering increased use and adherence.

摘要

目的

加利福尼亚州一项法律扩大了药剂师的执业范围,使其能够根据全州范围内的协议直接为患者提供自我给药的激素避孕服务。本研究旨在评估在该协议制定和实施之前,加利福尼亚州药剂师提供这项新服务的意愿。

设计

描述性、非实验性横断面研究。

地点

2014年8月至9月期间的加利福尼亚州。

参与者

在社区药房工作的加利福尼亚州药剂师。

干预措施

向1774名药剂师发送了参与在线调查的邀请。

主要结局指标

主要结局包括药剂师当前的执业情况、开具激素避孕处方的意愿、进行各种活动的舒适度、对避孕方法的了解、培训需求以及开具处方的障碍。

结果

共收到257份回复(回复率为14.5%)。其中,121名受访者符合纳入标准并被纳入分析。约一半的受访者(49.6%)报告在社区连锁药房工作,46.3%在独立药房工作,4.1%在其他社区药房环境中工作。大多数药剂师(72.7%)报告称他们可能会提供这项新服务。受访者表示对为患者提供短效(94.2%)和长效可逆避孕(81.7%)方面的教育感到舒适,以及识别激素避孕的药物相互作用(96.7%)。受访者指出时间限制(74.4%)、缺乏报销(63.6%)和责任担忧(62.0%)是开具激素避孕处方的障碍。

结论

加利福尼亚州药剂师在开具激素避孕处方方面表达了强烈的意愿和舒适度。为了成功实施,应解决药剂师的额外培训需求和障碍。这项新服务有很大潜力增加避孕措施的可及性,可能促进使用和依从性的提高。

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