Moore Alia, Ryan Sarah, Stamm Carol
a Division of General Internal Medicine , University of Colorado Anschutz Medical Campus , Aurora , Colorado , USA.
b Department of Correctional Health Services , Los Angeles County Department of Health Services , Los Angeles , California , USA.
Women Health. 2019 Apr;59(4):364-374. doi: 10.1080/03630242.2018.1487905. Epub 2018 Sep 24.
Federal regulations governing access to levonorgestrel (LNG) emergency contraception (EC) have evolved since its introduction in the 1990s. LNG EC was initially available by prescription only, but is now available over-the-counter to consumers of all ages. Nonetheless, consumers seeking EC in their communities may face ongoing barriers to access, including low stock and inaccurate information provided by pharmacy staff. We conducted a review of LNG EC secret shopper studies to describe changes in EC access and barriers over time. EC access was compared across all applicable studies, which were published during 2003-2016. When possible, reasons for EC unavailability, helpfulness of pharmacy staff when EC was not in stock, and accuracy of EC information provided by pharmacy staff were described. Overall, access to EC appeared to be improving. However, EC was unavailable during 31 percent of encounters. Pharmacy staff attributed this to "low demand" (30 percent) or EC being "out of stock" (21 percent). Personal objections (9 percent) and store policy (10 percent) were also cited in studies from earlier years. Inaccurate information provided by pharmacy staff persists regarding federal EC regulations, mechanism of action, and drug administration. Pharmacy staff should remain informed about EC and its regulations in order to reduce remaining access barriers.
自20世纪90年代左炔诺孕酮（LNG）紧急避孕（EC）问世以来，美国联邦政府对其使用的相关规定不断演变。最初，LNG紧急避孕药物仅能凭处方获取，如今各年龄段的消费者均可在柜台直接购买。尽管如此，在社区中寻求紧急避孕的消费者仍可能面临持续存在的获取障碍，包括库存不足以及药剂师提供的信息不准确等问题。我们对LNG紧急避孕药物的暗访研究进行了综述，以描述紧急避孕药物的获取情况及障碍随时间的变化。我们对2003年至2016年间发表的所有适用研究中的紧急避孕药物获取情况进行了比较。在可能的情况下，我们还描述了紧急避孕药物无法获取的原因、紧急避孕药物缺货时药剂师的帮助程度以及药剂师提供的紧急避孕药物信息的准确性。总体而言，紧急避孕药物的获取情况似乎正在改善。然而，在31%的暗访中，紧急避孕药物无法获取。药剂师将此归因于“需求低”（30%）或紧急避孕药物“缺货”（2l%）。早年的研究中也提到了个人反对意见（9%）和商店政策（10%）。药剂师提供的关于联邦紧急避孕药物法规、作用机制和药物管理的信息仍然不准确。药剂师应随时了解紧急避孕药物及其相关规定，以减少仍然存在的获取障碍。
