Using Pharmacies in Washington State to Expand Access to Emergency Contraception

Wells, Elisa; Hutchings, Jane; Gardner, Jacqueline S.; Winkler, Jennifer L.; Fuller, Timothy S.; Downing, Don; Shafer, R

doi:10.2307/2991505

Cited by 45 publications

(26 citation statements)

References 3 publications

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“…In this state, a collaborative drug therapy agreement for emergency contraception allows pharmacists to prescribe this therapy directly to women, either in response to an immediate need or in advance of need 13 . The pharmacist and the medical practitioner voluntarily enter into an agreement, under which the pharmacist receives the authority to write prescriptions based on a set of prescribing protocols.…”

Section: Discussionmentioning

confidence: 99%

Attitudes and practices of pharmacists towards emergency contraception in Durban, South Africa

Hariparsad

2001

The European Journal of Contraception & Reproductive Health

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Emergency contraception, which is used to prevent pregnancy following unprotected intercourse, could prove invaluable to a country like South Africa which has high fertility and pregnancy rates. However, the success of emergency contraception is dependent on the awareness, knowledge, attitudes and practices amongst health-care providers and the public towards it. The aim of this study was to assess the attitudes and practices of community pharmacists towards emergency contraception. The study was conducted in North and South Central Durban, South Africa. This questionnaire-based study sought from pharmacists the frequency of demand and supply of emergency contraception, as well as their attitudes and practices towards it. The sample included all 182 pharmacies located in the study area. A total of 96% of pharmacists had received requests for emergency contraception within the last year. On average, each pharmacist received 177 requests for emergency contraception. Sixty-nine per cent of pharmacists were in favor of making emergency contraceptive pills available without a prescription, 62% were already supplying emergency contraceptive pills without a prescription and 67% felt that it was important to increase public awareness regarding emergency contraception. Ninety-one per cent of pharmacists did not have any literature regarding emergency contraception to hand to clients, 68% had a private area in their pharmacy to counsel patients and 86% of pharmacists indicated that they discussed long-term contraception with clients. This study is the first in South Africa aimed at determining the utilization of emergency contraception. However, further studies are required in order to ascertain information that will assist in changing current health policies to improve those in reproductive health care.

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Section: Discussionmentioning

confidence: 99%

Attitudes and practices of pharmacists towards emergency contraception in Durban, South Africa

Hariparsad

2001

The European Journal of Contraception & Reproductive Health

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“…Various models of provision of ECP in pharmacies have been advocated 6 and are in place in several jurisdictions. [7][8][9] A pilot project was undertaken in 2001 in Toronto, Ontario, to increase the accessibility of emergency contraception. Emergency contraception, commonly known as "the morning-after pill," is underused because of a lack of awareness about its availability and the difficulty in accessing it within 72 hours following unprotected or unexpected sex.…”

Section: Introductionmentioning

confidence: 99%

Using a Secret Shopper to Evaluate Pharmacist Provision of Emergency Contraception

2004

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Introduction:Commonly known as "the morning-after pill," hormonal emergency contraception or the emergency contraceptive pill (ECP) is most effective if used within 72 hours of unprotected sex. In this paper we review a pilot project in Toronto, Ontario, that aimed to increase accessibility by allowing pharmacists to dispense ECP through a pharmacist-physician collaborative agreement, using a predefined protocol. Participating pharmacists received training in the pilot protocol and about ECP.To evaluate whether participating pharmacists were following the project protocol (i.e., giving accurate information to women requesting ECP and dispensing ECP appropriately), and to determine the quality of the pharmacist-patient encounter, we sent "secret shoppers" to participating pharmacies. Using a secret shopper to evaluate pharmacist provision of emergency contraceptionfilled in a questionnaire about the encounter and provided comments. Percentages were calculated for all variables.Results: For Script One encounters (n=17), most pharmacists followed the protocol correctly to dispense ECP. For Script Two encounters (n=17), 71.4% provided alternatives to ECP, but three pharmacists did not follow protocol and provided ECP. For Script One, 52.9% of pharmacists and for Script Two, 71.4%, provided a community referral for follow-up care. The majority of pharmacists (97%) treated the shopper with respect and 85% communicated clearly. Most of the shoppers' comments were positive and the main negative comment about the encounter was lack of privacy. Conclusions:The use of a secret shopper allowed the examination of the pharmacist-customer interaction to delineate issues of importance to the pilot project and provide feedback on areas that may require improvement in the pharmacy provision of emergency contraception, namely, dealing with women who do not qualify for ECP and providing women with community referrals for sexually transmitted infections or ongoing contraception.

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“…to see a physician, as in the states of Washington, Alaska and California through collaborative drug-therapy agreements [27]. To help educate women and men on emergency contraception, the Association of Reproductive Health Professionals in Washington DC and the Office of Population Research at Princeton University sponsor the toll-free Emergency Contraception…”

Section: Expert Opinionmentioning

confidence: 99%

Cost-effectiveness of emergency contraceptive pills in the public sector in the USA

Shochet

2003

Expert Review of Pharmacoeconomics & Outcomes Research

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Emergency contraception, which prevents pregnancy after unprotected sexual intercourse, has the potential to significantly reduce the incidence of unintended pregnancy and the consequent need for abortion. The cost-effectiveness of emergency contraceptive pills in the public sector in the USA is determined. The cost-savings when a single emergency contraceptive treatment is provided following unprotected intercourse are modeled along with when women are provided emergency contraceptive pills in advance. This resulted in a saving of USD 1.94-4.47 for each dollar spent on a single treatment of emergency contraceptive pills depending on the emergency contraceptive pill regimen and assumptions about savings from costs avoided by preventing mistimed births. The dedicated products Preven and Plan B are cost-effective even under the least favorable assumption that mistimed births, when prevented today, occur 2 years later. Each dollar spent on advance provision of Preven saves from USD 2.06 to 20.05, and each dollar spent on Plan B saves from USD 1.51 to 9.30, depending on the regular ongoing method of contraception, how consistently emergency contraceptive pills are used when needed, and whether mistimed births are averted forever or simply delayed. Emergency contraception is cost-effective whether provided when the emergency arises or in advance to be used as needed. More extensive use of emergency contraception could save considerable medical and social costs by reducing unintended pregnancies, which are expensive.

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Using Pharmacies in Washington State to Expand Access to Emergency Contraception

Cited by 45 publications

References 3 publications

Attitudes and practices of pharmacists towards emergency contraception in Durban, South Africa

Attitudes and practices of pharmacists towards emergency contraception in Durban, South Africa

Using a Secret Shopper to Evaluate Pharmacist Provision of Emergency Contraception

Cost-effectiveness of emergency contraceptive pills in the public sector in the USA

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