Zusman Enav Z, Munro Sarah, Norman Wendy V, Soon Judith A
Contraception and Abortion Research Team of the Women's Health Research Institute, UBC, and of the Collaboration for Outcomes Research and Evaluation.
Department of Obstetrics and Gynecology, University of British Columbia, Vancouver.
Can Pharm J (Ott). 2023 Jun 8;156(4):204-214. doi: 10.1177/17151635231176270. eCollection 2023 Jul-Aug.
Mifepristone for medical abortion was first dispensed by community pharmacists in Canada directly to patients in January 2017. We asked about pharmacists' experiences over their first year dispensing mifepristone in order to evaluate the frequency of the new practice and assess availability in urban/rural pharmacies.
From August to December 2019, we invited 433 community pharmacists who had completed a baseline survey at least 1 year prior to participate in a follow-up online survey. We summarized categorical data using counts and proportions and conducted a qualitative thematic analysis of open-ended responses.
Among 122 participants, 67.2% had dispensed the product, and 48.4% routinely stocked mifepristone. Pharmacists reported a mean of 26 and median of 3 (interquartile range, 1, 8) mifepristone prescriptions filled in their pharmacies in the previous year. Participants perceived that the benefits of making mifepristone available in pharmacies included increased abortion access for patients ( = 115; 94.3%), reduced pressure on the health care system ( = 104; 85.3%), increased rural and remote abortion access ( = 103; 84.4%) and increased interprofessional collaborations ( = 48; 39.3%). Few participants reported challenges to maintaining adequate stock of mifepristone, but these challenges included low demand ( = 24; 19.7%), short expiry dating ( = 12; 9.8%) and drug shortages ( = 8; 6.6%). The overwhelming majority, 96.7%, reported that their communities did not resist the provision of mifepristone by their pharmacy.
Participating pharmacists reported many benefits and very few barriers to stocking and dispensing mifepristone. Both urban and rural communities responded positively to enhanced access to mifepristone in their community.
Mifepristone is well accepted by pharmacists within the primary care system in Canada.
米非司酮用于药物流产于2017年1月在加拿大首次由社区药剂师直接配发给患者。我们询问了药剂师在配发米非司酮的第一年中的经历，以评估这种新做法的频率并评估城市/农村药房的可及性。
2019年8月至12月，我们邀请了433名至少在1年前完成了基线调查的社区药剂师参加一项在线随访调查。我们使用计数和比例汇总分类数据，并对开放式回答进行定性主题分析。
在122名参与者中，67.2%曾配发过该产品，48.4%常规储备米非司酮。药剂师报告称，前一年其药房平均配发了26份米非司酮处方，中位数为3份（四分位间距为1, 8）。参与者认为在药房提供米非司酮的好处包括增加患者的流产可及性（n = 115；94.3%）、减轻医疗保健系统的压力（n = 104；85.3%）、增加农村和偏远地区的流产可及性（n = 103；84.4%）以及增加跨专业合作（n = 48；39.3%）。很少有参与者报告在维持米非司酮充足库存方面存在挑战，但这些挑战包括需求低（n = 24；19.7%）、有效期短（n = 12；9.8%）和药品短缺（n = 8；6.6%）。绝大多数（96.7%）报告称其所在社区不抵制药房提供米非司酮。
参与调查的药剂师报告了储备和配发米非司酮的诸多好处以及极少的障碍。城市和农村社区对在其社区增加米非司酮的可及性均做出了积极回应。
米非司酮在加拿大初级保健系统内被药剂师广泛接受。
