J Am Pharm Assoc (2003). 2019 Sep-Oct;59(5):633-641. doi: 10.1016/j.japh.2019.05.015. Epub 2019 Jul 9.
The objective of this article is to review the current supply-side, demand-side, and regulatory landscape of pharmacist-prescribed hormonal contraception (HC) in the United States.
Pharmacists appear to be supportive of pharmacist-prescribed HC. However, support does not necessarily indicate likelihood to implement the practice, even when reimbursement mechanisms exist. The likelihood of implementation can be increased with education and training of HC prescribing. Previous investigations suggest that women broadly support accessing contraception within a pharmacy. Expanded access, where available, can improve rates of use and adherence. Women at higher risk for unintended pregnancy, such as younger women and women without health insurance, are likely to use the pharmacy to procure HC. Despite a willingness to pay for HC consultations with pharmacists, costs can remain a significant barrier for many women.
Expanding access to HC through pharmacist-prescriptive authority could help curb the rates of unintended pregnancy in the United States. Pharmacists are well positioned for such a role; however, significant barriers for pharmacists and patients remain. Examination of current implementation methods will assist policy makers in overcoming these barriers.
本文旨在回顾美国目前在供应方、需求方和监管方面的情况,以了解药师处方荷尔蒙避孕法(HC)的现状。
药师似乎支持由药师开具 HC 处方。然而,支持并不一定表示他们愿意实施这一做法,即使存在报销机制也是如此。通过 HC 处方培训和教育,可以提高实施的可能性。先前的调查表明,女性普遍支持在药房获取避孕药具。扩大可及性可以提高使用率和依从性。怀孕风险较高的女性,如年轻女性和没有医疗保险的女性,可能会选择去药房购买 HC。尽管愿意为与药剂师的 HC 咨询付费,但对许多女性来说,费用仍然是一个重大障碍。
通过扩大药师处方权限来增加 HC 的可及性,可能有助于降低美国的意外怀孕率。药剂师非常适合扮演这一角色;然而,药师和患者仍然面临着重大障碍。对当前实施方法的检查将有助于政策制定者克服这些障碍。