Changing Oral Contraceptives from Prescription to Over‐the‐Counter Status: An Opinion Statement of the Women's Health Practice and Research Network of the American College of Clinical Pharmacy

McIntosh, Jennifer; Rafie, Sally; Wasik, Mitzi; McBane, Sarah; Lodise, Nicole M.; El-Ibiary, Shareen Y.; Forinash, Alicia B.; Kachlic, Marlowe Djuric; Rowe, Emily; Besinque, Kathy

doi:10.1592/phco.31.4.424

Cited by 39 publications

(36 citation statements)

References 47 publications

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“…Furthermore, CPs may assume that patients who request a specific medicine are already knowledgeable about its use, and that asking questions and giving additional advice would be patronizing and could lead to a negative patient reaction [57,58]. Additionally, while U.S. pharmacy graduate programs have curricular requirements encompassing the various aspects of hormonal contraceptive service provision, including screening, prescribing, and monitoring [20], Brazilian pharmacy graduate programs are deficient in this respect.…”

Section: Discussionmentioning

confidence: 99%

“…Pharmacy-based screening for safe use of COCs, and counseling regarding the correct use, benefits, and adverse effects of COCs can improve patient adherence and safety [19]. Based on the results of previous studies indicating the potential and ability of CPs to provide effective clinical services in the community setting, the American College of Clinical Pharmacy (ACCP) supports the change of COCs to OTC with the condition that they are sold where a pharmacist is on duty [20]. The ACCP also states that there is a need to evaluate how COCs are actually dispensed, in order to identify the CPs’ role in COC access [20].…”

Section: Introductionmentioning

confidence: 99%

“…Based on the results of previous studies indicating the potential and ability of CPs to provide effective clinical services in the community setting, the American College of Clinical Pharmacy (ACCP) supports the change of COCs to OTC with the condition that they are sold where a pharmacist is on duty [20]. The ACCP also states that there is a need to evaluate how COCs are actually dispensed, in order to identify the CPs’ role in COC access [20]. However, to the best of our knowledge, there are few studies evaluating the COC dispensing practices of CPs either OTC or with a prescription.…”

Section: Introductionmentioning

confidence: 99%

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Use of Simulated Patients to Evaluate Combined Oral Contraceptive Dispensing Practices of Community Pharmacists

et al. 2013

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BackgroundCombined oral contraceptive (COC) use is the most commonly used reversible method of birth control. The incorrect use of COCs is frequent and one of the most common causes of unintended pregnancies. Community pharmacists (CPs) are in a strategic position to improve COC use because they are the last health professional to interact with patients before drug use.ObjectiveTo evaluate the COC dispensing practices of CPs in a developing country.MethodA cross-sectional study was conducted in community pharmacies of Assis and Ourinhos microregions, Brazil, between June 1, 2012, and October 30, 2012. Four simulated patients (SPs) (with counseled audio recording) visited community pharmacies with a prescription for Ciclo 21® (a COC containing ethinyl estradiol 30 mcg + levonorgestrel 15 mcg). The audio recording of every SP visit was listened to independently by 3 researchers to evaluate the COC dispensing practice. The percentage of CPs who performed a screening for safe use of COCs (i.e., taking of patients’ medical and family history, and measuring of blood pressure) and provided counseling, as well as the quality of the screening and counseling, were evaluated.ResultsOf the 185 CPs contacted, 41 (22.2%) agreed to participate in the study and finished the study protocol. Only 3 CPs asked the SP a question (1 question asked by each professional), and all of the questions were closed-ended, viz., “do you smoke?” (n = 2) and “what is your age?” (n = 1). None of the CPs measured the patient’s blood pressure. Six CPs provided counseling when dispensing COCs (drug dosing, 5 CPs; possible adverse effects, 2 CPs), and one CP provided counseling regarding both aspects.ConclusionThe CPs evaluated did not dispense COC appropriately and could influence in the occurrence of negatives therapeutic outcomes such as adverse effects and treatment failure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of Simulated Patients to Evaluate Combined Oral Contraceptive Dispensing Practices of Community Pharmacists

et al. 2013

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“…Although the relative safety of this method has been well-established and some have advocated for making OCs available over-the-counter (OTC) [2,3], women interested in starting or continuing with this method must still obtain a prescription from a health care provider in the US. One of the justifications for maintaining the prescription-only status is that, during their clinician visit, women are screened for health conditions such as hypertension and diabetes, which may increase their risk of myocardial infarction, stroke or other complications while taking OCs [4].…”

Section: Introductionmentioning

confidence: 99%

Contraindications to progestin-only oral contraceptive pills among reproductive-aged women

et al. 2012

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Background Progestin-only oral contraceptive pills (POPs) have fewer contraindications to use compared to combined pills. However, the overall prevalence of contraindications to POPs among reproductive aged women has not been assessed. Study Design We collected information on contraindications to POPs in two studies: 1) the Self-Screening Study, a sample of 1,267 reproductive aged women in the general population in El Paso, Texas, and 2) the Prospective Study of Oral Contraceptive (OC) Users, a sample of current OC users who obtained their pills in El Paso clinics (n=532) or over the counter (OTC) in Mexican pharmacies (n=514). In the Self-Screening Study, we also compared women’s self-assessment of contraindications using a checklist to a clinician’s evaluation. Results Only 1.6% of women in the Self-Screening Study were identified as having at least one contraindication to POPs. The sensitivity of the checklist for identifying women with at least one contraindication was 75.0% (95% CI: 50.6–90.4%), and the specificity was 99.4% (95% CI: 98.8–99.7%). In total, 0.6% of women in the Prospective Study of OC Users reported having any contraindication to POPs. There were no significant differences between clinic and OTC users. Conclusion The prevalence of contraindications to POPs was very low in these samples. POPs may be the best choice for the first OTC oral contraceptive in the US.

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“…In 2011 an opinion statement by the Women’s Health Practice and Research Network of the American College of Clinical Pharmacy highlighted the importance of changing the oral contraceptive pill to an over-the-counter product. 27 This statement emphasized the importance of making the contraceptive pill more accessible to help reduce the rate of unintended pregnancies. Before the oral contraceptive pill is made available over-the-counter is it vital that pharmacists are trained adequately on the various aspects of this service.…”

Section: Discussionmentioning

confidence: 99%

Young women's perceptions and experiences with contraception supply in community pharmacies

Fakih

Batra

Gatny

et al. 2015

Journal of the American Pharmacists Association

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Background Unintended pregnancy is a major public health problem in the United States.. Correct contraceptive use can reduce the rate of unintended pregnancy. Community pharmacies are well positioned to provide contraceptives and advise about contraception. Objectives (1) determine young women’s perceptions and experiences with contraception supply in community pharmacies and (2) identify whether very pharmacy characteristics predicted positive experiences. Design This study was comprised of two cross-sectional surveys including an online women’s pharmacy perceptions and experiences (PPE) survey and a faxed/observed survey of community pharmacies. Setting One County in Michigan, USA Participants Young women and community pharmacies Main outcome measure The two surveys were merged to explore pharmacy characteristics that may impact women’s perceptions and experiences with community pharmacies. Multiple logistic regression analysis was used to explore relationships between pharmacy characteristics and positive outcomes. Results The response rate for the PPE survey was 54% (n= 334/637). Data from all community pharmacies in the county was retrieved via fax (n= 41/94, 43.6%) or observation (n= 53/94, 56.4%). Women were included in this analysis if they indicated a regular (most commonly used) pharmacy in the county of interest (n=210). Over 50% of women (n= 125/210) visited a pharmacy more than once per month. Sixty percent of women were currently using something to prevent pregnancy (n=124/210, 60.8%). Thirty-five percent of women had a positive experience (n=73/210, 34.8%). In the multiple logistic regression, women who visited a chain pharmacy had almost 65% lower odds of an overall positive experience with their regular pharmacy, compared to women who visited a grocery or mass merchandise pharmacy (OR: 0.35, 95% CI: 0.16, 0.75). Conclusion Young women visit community pharmacies and use contraceptives frequently. Interventions need to be developed and implemented to improve young women’s perceptions and experiences with contraception at community pharmacies.

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Changing Oral Contraceptives from Prescription to Over‐the‐Counter Status: An Opinion Statement of the Women's Health Practice and Research Network of the American College of Clinical Pharmacy

Cited by 39 publications

References 47 publications

Use of Simulated Patients to Evaluate Combined Oral Contraceptive Dispensing Practices of Community Pharmacists

Use of Simulated Patients to Evaluate Combined Oral Contraceptive Dispensing Practices of Community Pharmacists

Contraindications to progestin-only oral contraceptive pills among reproductive-aged women

Young women's perceptions and experiences with contraception supply in community pharmacies

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