BACKGROUND

Unintended Pregnancy:

• A pregnancy that is unwanted (never wanting to become pregnant) or mistimed (wanting to be pregnant but not now)
• Associated adverse outcomes can be:
  • Delayed prenatal care
  • Premature birth,
  • Maternal depression ^2,3

STATISTICS

• Nearly 49% of pregnancies in the United States were unintended (per CDC).²
• In 2010, total public expenditures for unintended pregnancies were 21 billion dollars.³
  • Due to this financial impact, reducing unintended pregnancies is a national public health goal
  • The U.S. Department of Health and Human Services has included family planning in the Healthy People 2020 campaign
    • Targets improvement of pregnancy planning and prevention of unintended pregnancy
    • One solution is by increasing access to contraception.^2,3

PHARMACIST'S ROLE AND BENEFITS

Pharmacists are an easily accessible member of the healthcare team and possess the expertise and knowledge on contraceptive care. 

COUNSELING AND INFORMATION

• Contraceptive counseling should occur on both new and refill prescriptions. Statistics show that 41% of all unintended pregnancies occur in women who used contraceptives incorrectly or inconsistently.⁴

REPRODUCTIVE LIFE PLANE (RLP)

Pharmacists can work with patients to determine a comprehensive plan to determine patient goals regarding children and to encourage discussion about pregnancy planning.

• Ask the patients questions regarding their future reproductive plans.
  • Specific questions are listed in the Reproductive Life Plan Tool.
• Recommend appropriate contraceptives
  • Prescription
  • Nonprescription,
• Educate the patient about the product to ensure proper, consistent use
  • CDC website provides tools and resources to assist Reproductive Life Planning.⁵

OTC EMERGENCY CONTRACEPTION 

The availability of emergency contraceptives over the counter is essential to increase access and minimize delay of intake.

• Providing emergency contraceptives at the pharmacy is advantageous due to numerous pharmacy locations, hours of operations and convenience.
• Pharmacists can also offer additional counseling on future preventative contraception and in some states, even prescribe oral contraceptives.
• Additionally, receiving an emergency contraceptive from the pharmacy is a cost savings to the insurance carrier and the patient as an office visit is not required.

For more specific information regarding emergency contraceptives, access Emergency Contraception: A Guide for Pharmacies and Retailers

PHARMACISTS' CONTRACEPTION PRESCRIBING 

In some states, pharmacists can initiate hormonal contraception to patients as part of a statewide protocol.  Obtaining hormonal contraceptives at the pharmacy, removes many barriers to the access to care.  The patient does not need to make an appointment with the physician and then take time to get the prescription filled.  Adherence is improved, as the pharmacist can maintain and refill the prescription when necessary and according to state laws.  As an expert on medications, pharmacists may also select the most appropriate therapy based on the patient’s needs and then counsel on proper use and monitor outcomes.⁶ Providing these services can impact a pharmacy’s business by building patient loyalty, adherent refills and an overall increase in sales and prescriptions.

REGULATORY GUIDELINES

To date, Oregon, California and most recently Colorado have passed legislation allowing pharmacists to initiate prescriptions for hormonal contraceptives.  Other states such as Washington and Washington DC allow pharmacist initiated contraception through collaborative practice agreements (CPA).  More states are reviewing this process as well.

Each state has different requirements and protocols for pharmacist initiated hormonal contraceptive prescriptions.  This includes varying training requirements for the pharmacist, age and health status requirements for the patient, type of product prescribed and refill protocol.

For more state specific information and regulations, pharmacists should access their state board of pharmacy website.

Additional Information

National Alliance of State Pharmacy Associations. State Policy http://www.naspa.us/restopic/state-policy/

Kaiser Family Foundation. Women’s health policy.

http://www.kff.org/womens-health-policy/

The information provided here is for reference use only and does not constitute the rendering of clinical, legal or other professional advice by Health Mart.  Health Mart is not responsible for, nor will it bear any liability for, the accuracy, efficacy or reliability of the content provided herein and is not advocating any particular program or approach herein.  Readers should consult appropriate professionals for advice and assistance prior to making important decisions regarding their business.