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俄勒冈州药剂师开具激素避孕处方的经验。

Pharmacists' experience with prescribing hormonal contraception in Oregon.

作者信息

Rodriguez Maria I, Biel Frances M, Swartz Jonas J, Anderson Lorinda, Edelman Alison B

出版信息

J Am Pharm Assoc (2003). 2018 Nov-Dec;58(6):608-613. doi: 10.1016/j.japh.2018.06.020. Epub 2018 Sep 3.

Abstract

OBJECTIVES

To describe Oregon pharmacy practices in provision of hormonal contraception (HC) and evaluate if pharmacists' motivation to prescribe changed after 6 and 12 months of experience.

METHODS

Pharmacists practicing in Oregon who underwent the mandatory HC training were eligible to take this survey. The survey was launched 6 months after policy implementation; pharmacists who responded to the initial survey were eligible to be queried again at 12 months. Survey responses were anonymous, but pharmacists received a unique identifier so that responses could be linked between the 2 surveys. The survey consisted of pharmacy and pharmacist demographics and questions exploring attitudes toward prescribing HC and prescribing practices (e.g., cost, time needed for visit) and volume estimates. Descriptive statistics were used to analyze responses as well as the differences in key outcomes between 6 and 12 months.

RESULTS

A total of 732 pharmacists were eligible to take the survey; 121 pharmacists responded to the 6-month survey (16.5% response rate), and 62 completed the 12-month survey (52% response rate). A large increase in the distribution of pharmacists prescribing HC by zip code occurred between 6 and 12 months: 19% and 63%, respectively. At both 6 and 12 months, almost one-half of all pharmacists were billing insurance for the visit, and the average visit took less than 30 minutes. The top 3 motivators for providing HC did not change over time and included increasing access, reducing unintended pregnancy, and increasing pharmacist scope of practice.

CONCLUSION

One year after program implementation, pharmacist prescribing of HC continues to increase and is distributed widely across the state. A geographically diverse sample of Oregon pharmacists began prescribing of hormonal contraception within 12 months of Oregon's implementation of the new pharmacist provision policy. Their experience and the success of the program provide a roadmap for pharmacist participation to increase access to hormonal contraception.

摘要

目的

描述俄勒冈州药房提供激素避孕(HC)的实践情况,并评估药剂师在积累6个月和12个月经验后开处方的动机是否发生变化。

方法

在俄勒冈州执业并接受强制性HC培训的药剂师有资格参加本次调查。调查在政策实施6个月后启动;对初始调查做出回应的药剂师有资格在12个月时再次接受询问。调查回复是匿名的,但药剂师会收到一个唯一标识符,以便在两次调查之间关联回复。调查包括药房和药剂师的人口统计学信息,以及探索对开HC处方的态度、开处方实践(如费用、就诊所需时间)和数量估计的问题。描述性统计用于分析回复以及6个月和12个月之间关键结果的差异。

结果

共有732名药剂师有资格参加调查;121名药剂师回复了6个月的调查(回复率为16.5%),62名完成了12个月的调查(回复率为52%)。在6个月至12个月期间,按邮政编码划分的开HC处方的药剂师分布大幅增加:分别为19%和63%。在6个月和12个月时,几乎所有药剂师中有近一半为就诊收取保险费用,且平均就诊时间不到30分钟。提供HC的前三大动机没有随时间变化,包括增加可及性、减少意外怀孕以及扩大药剂师的执业范围。

结论

项目实施一年后,药剂师开HC处方的情况持续增加,且在全州广泛分布。俄勒冈州一个地理分布多样的药剂师样本在该州实施新的药剂师提供政策后的12个月内开始开激素避孕处方。他们的经验和项目的成功为药剂师参与增加激素避孕可及性提供了路线图。

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