Pharmacist Intentions to Prescribe Hormonal Contraception Following New Legislative Authority in California

摘要

Objective: Following a California law expanding pharmacists’ scope of practice to include directly providing self-administered hormonal contraception to patients pursuant to a statewide protocol, this study aimed to assess California pharmacists’ intentions to provide this new service prior to the protocol development and implementation. Design: Descriptive, nonexperimental, cross-sectional study. Setting: California between August and September 2014. Participants: California pharmacists working in community pharmacies. Intervention: Invitations to participate in the online survey were sent to 1774 pharmacists. Main Outcome Measures: Main outcomes included pharmacists’ current practices, intentions to prescribe hormonal contraception, comfort performing various activities, knowledge about contraceptive methods, training needs, and barriers to prescribing. Results: A total of 257 responses (14.5% response rate) were received. Of those, 121 respondents met inclusion criteria and were included in the analysis. About half of the respondents (49.6%) reported working in a community chain pharmacy, 46.3% in an independent pharmacy, and 4.1% in other community pharmacy settings. The majority (72.7%) of pharmacists reported that they would likely provide this new service. Respondents reported being comfortable educating patients on short-acting (94.2%) and long-acting reversible contraception (81.7%), as well as identifying drug interactions with hormonal contraception (96.7%). Respondents indicated time constraints (74.4%), lack of reimbursement (63.6%), and liability concerns (62.0%) as barriers to prescribing hormonal contraception. Conclusions: California pharmacists expressed strong intentions and comfort in prescribing hormonal contraception. Pharmacists’ additional training needs and barriers should be addressed for successful implementation. This new service has great potential to increase access to contraception, potentially fostering increased use and adherence.