Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341, United States; Oak Ridge Institute for Science and Education, 1299 Bethel Valley Rd, Oak Ridge, TN 37830, United States.
Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, GA 30341, United States.
Contraception. 2021 Feb;103(2):66-74. doi: 10.1016/j.contraception.2020.10.012. Epub 2020 Oct 29.
Increasingly, states authorize pharmacists to prescribe hormonal contraception to patients without a prescription from another healthcare provider. The purpose of this review is to investigate pharmacist and patient perspectives on pharmacist-prescribed contraception in the United States.
We searched Medline, Embase, PsycInfo, CINAHL, Scopus, and the Cochrane Library from inception through July 10, 2019. We included qualitative and mixed-methods studies, quantitative surveys, observational studies, and randomized trials in the United States. Risk of bias was assessed using tools for quantitative and qualitative studies.
Fifteen studies met inclusion criteria, including studies on pharmacists and student pharmacists (n = 9), patients (n = 5), and both (n = 1). Study samples ranged from local to national. Studies had moderate to high risk of bias, primarily due to low response rates and lack of validated instruments. Most pharmacists (57-96%) across four studies were interested in participating in pharmacist-prescribed contraception services. Among patients, 63-97% across three studies supported pharmacist-prescribed contraception, and 38-68% across four studies intended to participate in these services. At least half of pharmacists across four studies felt comfortable prescribing contraception, though pharmacists identified additional training needs. Pharmacists and patients identified several reasons for interest in pharmacist-prescribed contraception services, including increasing patient access, reducing unintended pregnancies, and offering professional development for pharmacists. They also identified barriers, including payment, time and resource constraints, liability, and patient health concerns.
Most pharmacists and patients across 15 studies were interested in expanded access to contraception through pharmacist-prescribed contraception. Findings on facilitators and barriers may inform implementation efforts.
Pharmacist-prescribed contraception is a strategy to expand patient access to contraception. Reducing barriers to implementation could improve participation among pharmacists and patients.
越来越多的州授权药剂师在没有其他医疗保健提供者处方的情况下为患者开具激素避孕药。本研究旨在调查美国药剂师和患者对药剂师处方避孕药的看法。
我们检索了 Medline、Embase、PsycInfo、CINAHL、Scopus 和 Cochrane Library 从建库到 2019 年 7 月 10 日的数据。我们纳入了在美国开展的定性和混合方法研究、定量调查、观察性研究和随机试验。使用定量和定性研究的工具评估偏倚风险。
15 项研究符合纳入标准，包括关于药剂师和实习药剂师（n=9）、患者（n=5）和两者（n=1）的研究。研究样本范围从局部到全国。研究的偏倚风险较高，主要是由于低应答率和缺乏验证工具。四项研究中有 57%至 96%的药剂师对参与药剂师处方避孕药服务感兴趣。三项研究中有 63%至 97%的患者支持药剂师处方避孕药，四项研究中有 38%至 68%的患者打算参与这些服务。至少有一半的药剂师在四项研究中感到能够开具避孕药处方，但药剂师认为需要额外的培训。药剂师和患者都对参与药剂师处方避孕药服务的原因表示了兴趣，包括增加患者获得避孕药的机会、减少意外怀孕和为药剂师提供专业发展。他们还确定了一些障碍，包括支付、时间和资源限制、责任和患者健康问题。
15 项研究中，大多数药剂师和患者对通过药剂师处方避孕药扩大避孕药的可及性感兴趣。对促进因素和障碍的研究结果可以为实施工作提供信息。
药剂师处方避孕药是扩大患者获得避孕药机会的一种策略。减少实施障碍可以提高药剂师和患者的参与度。
