Department of Pediatrics, Children's Health Services Research, Indiana University School of Medicine, Indianapolis, Indiana.
Department of Pharmacy, UC San Diego Health, San Diego, California.
J Adolesc Health. 2018 Jul;63(1):32-36. doi: 10.1016/j.jadohealth.2017.11.303. Epub 2018 Feb 21.
Since restrictions on nonprescription sales were removed in 2013, levonorgestrel emergency contraception (EC) should be available without a prescription at pharmacies for consumers of all genders and ages. Using mystery callers, we assessed variations in availability of and access to EC.
In 2015-2016, three sets of mystery callers (two female physicians, two adolescent females, and two adolescent males) each called all licensed retail pharmacies in five U.S. cities using standardized call scripts. Scripts assessed same-day availability and subsequent access to EC for 17-year-olds. Data on various characteristics of calls were collected and compared by caller type.
Among the 993 pharmacies called, same-day availability for EC was approximately 80%, with no differences by caller types (p = .34). However, 10.7% of calls made by the adolescent male caller and 8.3% made by the adolescent female caller resulted in incorrectly being told they could not obtain EC based on age, compared to only 1.6% of calls made by the physician (p < .01). Pharmacy staff stated correctly that EC was available over-the-counter more often to adolescent male callers (62.0%) than adolescent females (51.6%) or female physicians (57%) (p < .01). Physicians were more likely to be placed on hold, talk to a pharmacist, or be transferred to a pharmacist (p < .01) than adolescents.
Persistent barriers to accessing EC exist for adolescents despite regulatory changes to make EC available over-the-counter, especially for females. Additional work to remove these barriers is needed to assure timely access for those who require effective pregnancy prevention.
自 2013 年取消非处方销售限制以来，左炔诺孕酮紧急避孕药（EC）应在所有性别和年龄段的消费者均可在药店无需处方购买。我们使用神秘访客评估 EC 的供应和获取情况的变化。
在 2015-2016 年，三组神秘访客（两名女医生、两名青少年女性和两名青少年男性）使用标准化的通话脚本，分别致电美国五个城市的所有持照零售药店。脚本评估了 17 岁青少年当天获得 EC 的可用性和随后获得 EC 的途径。根据访客类型收集和比较了有关各种通话特征的数据。
在所拨打的 993 家药店中，EC 的当天可用性约为 80%，不同访客类型之间没有差异（p=0.34）。然而，10.7%的由青少年男性访客打的电话和 8.3%的由青少年女性访客打的电话错误地被告知他们因年龄无法获得 EC，而只有 1.6%的由医生打的电话（p<0.01）。药店工作人员正确表示，EC 更经常向青少年男性访客（62.0%）而不是青少年女性（51.6%）或女医生（57%）提供非处方（p<0.01）。与青少年相比，医生更有可能被保留、与药剂师交谈或被转接到药剂师（p<0.01）。
尽管监管改革使 EC 可以在柜台购买，但青少年获得 EC 的障碍仍然存在，尤其是对女性而言。需要做更多的工作来消除这些障碍，以确保那些需要有效避孕的人能够及时获得。
