Mody Sheila K, Rafie Sally, Hildebrand Marisa, Oakley Lisa P
Division of Family Planning, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, United States.
Department of Pharmacy, UC San Diego Health, San Diego, CA, United States.
Contraception. 2019 Dec;100(6):464-467. doi: 10.1016/j.contraception.2019.08.012. Epub 2019 Sep 4.
To understand knowledge, current practices, barriers and facilitators for pharmacists prescribing emergency contraception (EC).
We conducted a cross-sectional survey among California community pharmacists. We distributed the online survey, consisting of 34 close-ended questions, to members of the California Pharmacists Association via its email listserve.
We collected a survey response rate of 7%. Although 95% of respondents were aware of the statewide protocol allowing pharmacists to prescribe EC, only 36% of respondents reported prescribing EC in the previous year. Prescribing practices within the past year differed by type of pharmacy. We found no correlation between EC knowledge and prescribing practices. The most frequently reported facilitators of EC prescribing by pharmacists were the statewide protocol, a continuing education training program, and patient need or demand for EC. The most reported barriers to prescribing EC were lack of payment for pharmacist patient care services by insurers, increased responsibility or liability concerns, and time constraints. When asked about their intention to prescribe in the upcoming year, responses differed based on whether or not their pharmacies currently stocked EC.
This exploratory study identifies key facilitators, such as the statewide protocol, and key barriers, such as lack of payment by insurance companies for pharmacist services.
The findings of this study could guide future multi-component implementation strategies such as academic detailing that specifically address concerns about increased responsibility, liability and time constraints. In addition, payment for pharmacist services could be addressed at a policy level since this was a barrier to pharmacist EC prescribing.
了解药剂师开具紧急避孕药（EC）的知识、当前做法、障碍和促进因素。
我们对加利福尼亚州的社区药剂师进行了一项横断面调查。我们通过加利福尼亚药剂师协会的电子邮件列表向其成员分发了包含34个封闭式问题的在线调查问卷。
我们的调查回复率为7%。尽管95%的受访者知晓全州允许药剂师开具紧急避孕药的方案，但只有36%的受访者报告在前一年开具过紧急避孕药。过去一年的开具情况因药房类型而异。我们发现紧急避孕药知识与开具做法之间没有相关性。药剂师开具紧急避孕药最常报告的促进因素是全州方案、继续教育培训项目以及患者对紧急避孕药的需求。报告最多的开具紧急避孕药的障碍是保险公司未支付药剂师患者护理服务费用、责任或 liability 担忧增加以及时间限制。当被问及他们在来年开具紧急避孕药的意图时，回复因他们的药房目前是否备有紧急避孕药而有所不同。
这项探索性研究确定了关键促进因素，如全州方案，以及关键障碍，如保险公司未支付药剂师服务费用。
本研究的结果可为未来的多组件实施策略提供指导，如学术详细说明，专门解决对责任、 liability 和时间限制增加的担忧。此外，由于这是药剂师开具紧急避孕药的一个障碍，药剂师服务的支付问题可在政策层面得到解决。
