J Am Pharm Assoc (2003). 2024 Jan-Feb;64(1):226-234.e2. doi: 10.1016/j.japh.2023.08.005. Epub 2023 Aug 16.
In the United States, more than 19 million people of reproductive age need access to publicly funded hormonal contraception or live in areas where it is not readily available. These include rural areas of the country, commonly known as contraception deserts. Pharmacist prescribing has been proposed to increase access, but little is known about its implementation in such areas.
This study quantified the extent of pharmacists' furnishing (prescribing) of hormonal contraception in California's Central Valley community pharmacies and identified barriers and facilitators to implementation.
The researchers conducted a cross-sectional, mixed methods, observational study by (1) contacting all community pharmacies in the 11 counties of the Central Valley to determine furnishing rates and (2) surveying and interviewing pharmacies that indicated they furnished hormonal contraception.
Overall, 13% of pharmacies within the Central Valley reported that they furnished hormonal contraception. Pharmacists reported that barriers to furnishing included costs to patients and the pharmacy, lack of time and staff, lack of training and certifications, limited patient awareness of pharmacists' ability to furnish, pharmacists' limited confidence in furnishing, and patient use of emergency contraception as an alternative to hormonal contraception. Pharmacists reported that patients often sought hormonal contraception from pharmacists owing to ease of accessibility to a pharmacist; some other facilitators included advertising, confidentiality, low cost to patients, and referrals from other providers.
Common barriers were identified across pharmacies that furnished hormonal contraception, indicating the need for strategies that reduce these barriers to help expand patient's access to these services and to increase pharmacists' ability and confidence to prescribe.
在美国，超过 1900 万处于生育年龄的人需要获得公共资金资助的激素避孕措施，或者生活在难以获得该措施的地区。这些地区包括美国的农村地区，通常被称为避孕荒漠。有人提议让药剂师开处方来增加获得途径，但在这些地区实施的情况知之甚少。
本研究量化了加利福尼亚州中央谷地区社区药房药剂师提供（开处方）激素避孕措施的程度，并确定了实施过程中的障碍和促进因素。
研究人员通过（1）联系中央谷 11 个县的所有社区药房，以确定提供服务的比例，以及（2）对表示提供激素避孕措施的药房进行调查和访谈，进行了一项跨区域、混合方法、观察性研究。
总体而言，中央谷地区 13%的药房表示提供了激素避孕措施。药剂师报告说，提供服务的障碍包括患者和药房的成本、缺乏时间和人员、缺乏培训和认证、患者对药剂师提供能力的认识有限、药剂师提供服务的信心有限，以及患者将紧急避孕药作为激素避孕药的替代选择。药剂师报告说，由于患者更容易接触到药剂师，因此经常向药剂师寻求激素避孕措施；一些其他的促进因素包括广告、保密性、对患者的低费用，以及来自其他提供者的转介。
已确定提供激素避孕措施的药房之间存在常见障碍，这表明需要采取策略来减少这些障碍，以帮助扩大患者获得这些服务的途径，并提高药剂师开具处方的能力和信心。
