Assessing Pharmacist and Clinician Perspectives on Pharmacist Prescribed Hormonal Contraceptives.

BACKGROUND: After the Dobbs, et al ruling in June 2022 by the US Supreme Court eliminated the federal right to abortion care, concerns about access to reproductive health have been elevated. Barriers to contraception use consist of knowledge deficits, unfavorable legal rulings, cost and insurance coverage, unnecessary medical practices and health care inequities. Pharmacists are the most accessible health care providers who are positioned to mitigate these barriers and expand reproductive health access through scope of practice expansion. The American College of Obstetricians and Gynecologists (ACOG) has expressed their support for pharmacists prescribing hormonal contraceptives. As of October 2022, 22 states and jurisdictions have a protocol in place to allow for autonomous prescribing of hormonal contraceptives by pharmacists.1 OBJECTIVE: The objective of this study was to simultaneously assess pharmacist and clinician perspectives of all ages and sexual identities, on pharmacist prescribed hormonal contraceptives and barriers faced in accessing contraception.

METHODS: The researchers conducted an Institutional Review Board (IRB)-approved observational study via a cross-sectional survey distributed to licensed pharmacists and clinicians from October 2022 to February 2023. The survey population included those who were 18 years or older, English speaking, and recruited both in person and through email listservs. The survey assessed barriers to contraception access, perspectives towards pharmacist prescribed hormonal contraception, likelihood of receiving pharmacist prescribed hormonal contraception and pharmacist comfort with prescribing hormonal contraceptives.

RESULTS: Nearly 38% of respondents reported having ever experienced ≥1 barrier in accessing contraception which were having a time barrier or delay in appointment, a cost/copay barrier, and or lacking an obstetrician/gynecologist (OB/GYN). Eighty-one percent of all respondents agreed or strongly agreed with pharmacist-prescribed hormonal contraception. Sixty-one percent of pharmacists said they are either very or somewhat comfortable prescribing hormonal contraception. Pharmacists' most commonly reported concerns were payment for services, lack of access to patient medical records, and patient safety.

CONCLUSIONS: After Dobbs, et al, the majority of pharmacists and clinicians in Rhode Island support pharmacist prescribed hormonal contraceptives and the most frequently reported barriers faced in accessing contraception can be overcome through pharmacist prescribing. The information and data gathered from this study supported legislation for pharmacist prescriptive authority for hormonal contraception in Rhode Island.