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Isaac S, Mirzaei A, McLachlan AJ, Chaar BB. Conscientious objection - a cross-sectional, vignette-based, mixed methods exploration of Australian pharmacists' perspectives. J Pharm Policy Pract 2024; 17:2323086. [PMID: 38572377 PMCID: PMC10989204 DOI: 10.1080/20523211.2024.2323086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Background: Conscientious objection (CO) in healthcare is a controversial topic. Some perceive CO as freedom of conscience, others believe their professional duty-of-care overrides personal-perspectives. There is a paucity of literature pertaining to pharmacists' perspectives on CO. Aim: To explore Australian pharmacists' decision-making in complex scenarios around CO and reasons for their choices. Method: A cross-sectional, qualitative questionnaire of pharmacists' perspectives on CO. Vignette-based questions were about scenarios related to medical termination, emergency contraception, IVF surrogacy for a same-sex couple and Voluntary Assisted Dying (VAD) Results: Approximately half of participants (n = 223) believed pharmacists have the right to CO and most agreed to supply prescriptions across all vignettes. However, those who chose not to supply (n = 20.9%), believed it justifiable, even at the risk of patients failing to access treatment. Strong self-reported religiosity had a statistically significant relationship with decisions not to supply for 3 of 4 vignettes. Three emergent themes included: ethical considerations, the role of the pharmacist and training and guidance. Conclusion: This exploratory study revealed perspectives of Australian pharmacists about a lack of guidance around CO in pharmacy. Findings highlighted the need for future research to investigate and develop further training and professional frameworks articulating steps to guide pharmacists around CO.
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Affiliation(s)
- Sami Isaac
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Ardalan Mirzaei
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Andrew J. McLachlan
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Betty B. Chaar
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Blake BN, Bookbinder S, Lazenby G, Marshall A, Weed E, Meglin M. Knowledge of Oral Emergency Contraception Among Pharmacy Students. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:40-45. [PMID: 38288390 PMCID: PMC10823165 DOI: 10.1089/whr.2023.0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/31/2024]
Abstract
Background Access to emergency contraception is an important consideration in preventing unintended pregnancies. Inconsistent information about emergency contraceptive given to patients at retail pharmacies may limit access. Objective In this study, we aimed to assess pharmacy students' knowledge of oral emergency contraception. Methods Students in a Doctor of Pharmacy program completed a confidential survey about their knowledge of and training on oral emergency contraception. Respondents self-reported demographics included age, race, ethnicity, gender, and year in pharmacy school. The survey questions assessed student knowledge of indications, availability, side effects, and mechanisms of action of oral emergency contraception, as well as their training on emergency contraception. Chi-squared and Fisher's exact tests were used to determine if demographics influenced knowledge outcomes. A multivariate logistic regression, including age, gender, ethnicity, religion, year of training, hours of education, and source of knowledge acquisition, was used to adjust for confounding variables. Results Among 296 pharmacy students, 31% (92/296) completed the survey. Among respondents, 34% (31/92) showed adequate knowledge of oral emergency contraception based on four critical knowledge questions. Third- and fourth-year students were more likely to have adequate knowledge than first- and second-year students (odds ratio [OR], 2.70; confidence interval [95% CI], 1.07-6.80). Students who reported learning about emergency contraception through reading assignments were more likely to have adequate knowledge than students who did not report learning from reading assignments (OR, 2.09; 95% CI, 1.30-3.35). Conclusions Most pharmacy students at a single academic center did not have adequate knowledge of oral emergency contraception. These findings highlight the need for trainings to improve pharmacy student knowledge of oral emergency contraception.
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Affiliation(s)
- Bria Nikole Blake
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Samantha Bookbinder
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Gweneth Lazenby
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Amari Marshall
- College of Pharmacy, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Elizabeth Weed
- Department of Clinical Pharmacy and Outcome Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Michelle Meglin
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA
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Atkins K, Kennedy CE, Yeh PT, Narasimhan M. Over-the-counter provision of emergency contraceptive pills: a systematic review. BMJ Open 2022; 12:e054122. [PMID: 35288384 PMCID: PMC8921871 DOI: 10.1136/bmjopen-2021-054122] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 02/10/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To synthesise evidence around over-the-counter (OTC) emergency contraceptive pills (ECPs) to expand the evidence base on self-care interventions. DESIGN Systematic review (PROSPERO# CRD42021231625). ELIGIBILITY CRITERIA We included publications comparing OTC or pharmacy-access ECP with prescription-only ECPs and measuring ECP uptake, correct use, unintended pregnancy, abortion, sexual practices/behaviour, self-efficacy and side-effects/harms. We also reviewed studies assessing values/preferences and costs of OTC ECPs. DATA SOURCES We searched PubMed, CINAL, LILACS, EMBASE, clinicaltrials.gov, WHO International Clinical Trials Registry Platform, Pan African Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, Cochrane Fertility Regulation and International Consortium for Emergency Contraception through 2 December 2020. RISK OF BIAS For trials, we used Cochrane Collaboration's tool for assessing risk of bias; for other studies, we used the Evidence Project risk of bias tool. DATA EXTRACTION AND SYNTHESIS We summarised data in duplicate using Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence Profile tables, reporting findings by study design and outcome. We qualitatively synthesised values/preferences and cost data. RESULTS We included 19 studies evaluating effectiveness of OTC ECP, 56 on values/preferences and 3 on costs. All studies except one were from high-income and middle-income settings. Broadly, there were no differences in overall ECP use, pregnancy or sexual behaviour, but an increase in timely ECP use, when comparing OTC or pharmacy ECP to prescription-only ECP groups. Studies showed similar/lower abortion rates in areas with pharmacy availability of ECPs. Users and providers generally supported OTC ECPs; decisions for use were influenced by privacy/confidentiality, convenience, and cost. Three modelling studies found pharmacy-access ECPs would lower health sector costs. CONCLUSION OTC ECPs are feasible and acceptable. They may increase access to and timely use of effective contraception. Existing evidence suggests OTC ECPs do not substantively change reproductive health outcomes. Future studies should examine OTC ECP's impacts on user costs, among key subgroups and in low-resource settings.
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Affiliation(s)
- Kaitlyn Atkins
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Caitlin E Kennedy
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ping Teresa Yeh
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Pharmacy-based initiatives to reduce unintended pregnancies: A scoping review. Res Social Adm Pharm 2021; 17:1673-1684. [PMID: 33582078 DOI: 10.1016/j.sapharm.2021.01.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/30/2021] [Accepted: 01/31/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Community pharmacy contraception services are thought to improve access, with the potential to reduce the persistent sexual and reproductive health inequities observed globally. OBJECTIVES We aimed to identify the range of pharmacy-based initiatives addressing unintended pregnancy in the primary literature and examine their feasibility, acceptability and effectiveness. METHOD Using the Joanna Briggs Institute Methodology for Scoping Reviews, we searched seven bibliographic databases using combinations of keywords and subject headings for related to contraception and community pharmacy. Studies of any design undertaken in high income countries for reproductive-aged women were eligible provided they evaluated intervention or legislation after the implementation of these initiatives. Included articles were critically appraised and findings summarised narratively. RESULTS We identified 49 articles, 80% of which involved pharmacist supply of emergency contraception (EC), 14% of regular contraception methods, and 6% involved adjuncts of EC dispensing: counselling (2%) and bridging initiatives to link clients with regular contraception (4%). EC initiatives were perceived as feasible and were facilitated by interdisciplinary partnerships but there are persistent barriers to the provision of initiatives congruous with the retail pharmacy setting. Furthermore, consumers may be reluctant to receive contraceptive counselling from pharmacists but often value the convenience and anonymity pharmacy services offer. Overall, interventions improved access to contraceptive products but did not consistently reduce inequities, and the health benefits of pharmacy initiatives are either small (EC) or lacking description in the literature (other contraceptive methods and contraceptive counselling). CONCLUSIONS Pharmacy initiatives may not negate all barriers to access or reduce unintended pregnancy rates, however they are valued by pharmacists and consumers. Evidence gaps including the lack of description of health outcomes of regular contraception provision, contraceptive counselling and the perceived barriers and facilitators of access and provision from end-user perspectives, should be pursued in future research, to establish initiatives' utility and effectiveness.
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Gray NJ. A Call for Action: Supporting and Engaging Pharmacists in the Provision of Emergency Contraception. J Adolesc Health 2018; 63:1-2. [PMID: 30060845 DOI: 10.1016/j.jadohealth.2018.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 05/07/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Nicola J Gray
- Green Line Consulting LimitedManchester, United Kingdom
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Shatnawi A, Latif DA. A qualitative assessment of West Virginia pharmacist activities and attitude in diabetes management. J Eval Clin Pract 2017; 23:586-592. [PMID: 27882650 DOI: 10.1111/jep.12677] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/18/2016] [Accepted: 10/19/2016] [Indexed: 01/13/2023]
Abstract
AIMS AND OBJECTIVES The role of pharmacists in chronic disease state management has been shown to significantly improve patient health outcomes and reduce overall health care costs. The current study is designed to assess the roles and attitudes of West Virginia (WV) pharmacists toward diabetes, evaluate services provided, address pharmacist clinical understanding and training, and demonstrate the challenges that limit pharmacists ability to deliver an efficient disease state management. METHODS We invited 435 preceptors affiliated with the University of Charleston School of Pharmacy to participate in the study using Qualtrics online survey software. The survey was divided into sections related to pharmacists, practice environment, pharmacist's roles in diabetes management, and challenges faced that limit their ability to deliver effective care to diabetic patients. Data were analyzed using 1-way analysis of variance, and a P value ≤.05 was considered statistically significant. RESULTS Of all eligible invited preceptors, 104 accessed the online survey based on the Qualtrics tracking tool, while 58 participated in the survey with a 56% response rate. Generally, WV pharmacists have positive attitudes regarding the provision of primary activities related to drug use and its associated problems. However, we report that WV pharmacists are less involved in providing education or recommendations regarding diabetes-associated risk factors such as nephropathy, retinopathy, foot care, and gastroparesis. In addition, the majority of pharmacists indicated that they face many challenges related to patient and the practice site environment that limit their ability to provide optimum diabetes patient care services. CONCLUSION Despite the mounting evidence that pharmacists can improve diabetic patient outcomes while significantly reducing overall costs, WV pharmacists are less involved in providing education or counseling in a variety of areas related to disease state management. In addition, identifying pharmacist challenges provides significant information for future planning toward improving diabetic patient care.
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Affiliation(s)
- Aymen Shatnawi
- Department of Pharmaceutical and Administrative Sciences, University of Charleston School of Pharmacy, Charleston, West Virginia, USA
| | - David A Latif
- Department of Pharmaceutical and Administrative Sciences, University of Charleston School of Pharmacy, Charleston, West Virginia, USA
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Pharmacy provision of sexual and reproductive health commodities to young people: a systematic literature review and synthesis of the evidence. Contraception 2016; 95:339-363. [PMID: 28025018 DOI: 10.1016/j.contraception.2016.12.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 11/11/2016] [Accepted: 12/17/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND We conducted a systematic review of peer-reviewed literature on youth access to, use of and quality of care of sexual and reproductive health (SRH) commodities through pharmacies. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, we searched for publications from 2000 to 2016. To be eligible for inclusion, articles had to address the experiences of young people (aged 25 years and below) accessing SRH commodities (e.g., contraception, abortifacients) via pharmacies. The heterogeneity of the studies precluded meta-analysis - instead, we conducted thematic analysis. RESULTS A total of 2842 titles were screened, and 49 met the inclusion criteria. Most (n=43) were from high-income countries, and 33 examined emergency hormonal contraception provision. Seventeen focused on experiences of pharmacy personnel in provision, while 28 assessed client experiences. Pharmacy provision of SRH commodities was appealing to and utilized by youth. Increasing access to SRH commodities for youth did not correspond to increases in risky sexual behavior. Both pharmacists and youth had reservations about the ease of access and its impact on sexual behaviors. In settings where regulations allowing pharmacy access were established, some pharmacy personnel created barriers to access or refused access entirely. DISCUSSION With training and support, pharmacy personnel can serve as critical SRH resources to young people. Further research is needed to better understand how to capitalize on the potential of pharmacy provision of SRH commodities to young people without sacrificing qualities which make pharmacies so appealing to young people in the first place.
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Chaze F, Thomson MS, George U, Guruge S. Role of Cultural Beliefs, Religion, and Spirituality in Mental Health and/or Service Utilization among Immigrants in Canada: A Scoping Review. ACTA ACUST UNITED AC 2015. [DOI: 10.7870/cjcmh-2015-015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Fleming ML, Barner JC, Brown CM, Shepherd MD, Strassels SA, Novak S. Pharmacists’ training, perceived roles, and actions associated with dispensing controlled substance prescriptions. J Am Pharm Assoc (2003) 2014; 54:241-50. [DOI: 10.1331/japha.2014.13168] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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10
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Whelan AM, Langille DB, Hurst E. Nova Scotia pharmacists' knowledge of, experiences with and perception of factors interfering with their ability to provide emergency contraceptive pill consultations. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2013; 21:314-21. [DOI: 10.1111/ijpp.12017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 11/15/2012] [Indexed: 11/26/2022]
Abstract
Abstract
Objective
The objective of this research was to explore pharmacists' knowledge of, experiences with and perception of factors interfering with their ability to provide non-prescription emergency contraceptive pill consultations in the Canadian province of Nova Scotia.
Methods
A self-administered paper questionnaire was mailed, using Dillman's tailored design method, to all pharmacists (n = 1123) registered with the Nova Scotia College of Pharmacists.
Key findings
The response rate was 53.0% (595/1123), with 451 respondents working in community practice. Most respondents reported that they had provided consultations for the emergency contraceptive product Plan B since it became available without a prescription (93.6%), and that Plan B is kept behind the pharmacy counter (83.6%). Pharmacists most frequently (47.8%) reported spending 6–10 min providing Plan B consultations. Respondents were generally knowledgeable about Plan B; however, only 39.2% knew that it can be effective for up to 5 days and 69.3% knew that the incidence of vomiting is less than 50%. The factors interfering the most with providing Plan B consultations were lack of privacy (46.1%) and lack of staff to cover during the consultation (50.9%).
Conclusions
In general, Nova Scotia pharmacists are knowledgeable about emergency contraceptive pills; however, education regarding effective timing for use of such pills would be helpful. Private areas for counselling and consideration of pharmacy staffing schedules in community pharmacies may help address pharmacist concerns regarding their ability to provide Plan B consultations.
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Affiliation(s)
- Anne Marie Whelan
- College of Pharmacy, Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Donald B Langille
- Department of Community Health & Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Eileen Hurst
- Department of Community Health & Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
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Gavaza P, Brown CM, Lawson KA, Rascati KL, Wilson JP, Steinhardt M. Examination of pharmacists’ intention to report serious adverse drug events (ADEs) to the FDA using the theory of planned behavior. Res Social Adm Pharm 2011; 7:369-82. [DOI: 10.1016/j.sapharm.2010.09.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Revised: 09/02/2010] [Accepted: 09/02/2010] [Indexed: 11/30/2022]
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Eades CE, Ferguson JS, O'Carroll RE. Public health in community pharmacy: a systematic review of pharmacist and consumer views. BMC Public Health 2011; 11:582. [PMID: 21777456 PMCID: PMC3146877 DOI: 10.1186/1471-2458-11-582] [Citation(s) in RCA: 318] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 07/21/2011] [Indexed: 11/29/2022] Open
Abstract
Background The increasing involvement of pharmacists in public health will require changes in the behaviour of both pharmacists and the general public. A great deal of research has shown that attitudes and beliefs are important determinants of behaviour. This review aims to examine the beliefs and attitudes of pharmacists and consumers towards pharmaceutical public health in order to inform how best to support and improve this service. Methods Five electronic databases were searched for articles published in English between 2001 and 2010. Titles and abstracts were screened by one researcher according to the inclusion criteria. Papers were included if they assessed pharmacy staff or consumer attitudes towards pharmaceutical public health. Full papers identified for inclusion were assessed by a second researcher and data were extracted by one researcher. Results From the 5628 papers identified, 63 studies in 67 papers were included. Pharmacy staff: Most pharmacists viewed public health services as important and part of their role but secondary to medicine related roles. Pharmacists' confidence in providing public health services was on the whole average to low. Time was consistently identified as a barrier to providing public health services. Lack of an adequate counselling space, lack of demand and expectation of a negative reaction from customers were also reported by some pharmacists as barriers. A need for further training was identified in relation to a number of public health services. Consumers: Most pharmacy users had never been offered public health services by their pharmacist and did not expect to be offered. Consumers viewed pharmacists as appropriate providers of public health advice but had mixed views on the pharmacists' ability to do this. Satisfaction was found to be high in those that had experienced pharmaceutical public health Conclusions There has been little change in customer and pharmacist attitudes since reviews conducted nearly 10 years previously. In order to improve the public health services provided in community pharmacy, training must aim to increase pharmacists' confidence in providing these services. Confident, well trained pharmacists should be able to offer public health service more proactively which is likely to have a positive impact on customer attitudes and health.
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Affiliation(s)
- Claire E Eades
- Department of Psychology, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
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Mackin ML, Clark K. Emergency contraception in Iowa pharmacies before and after over-the-counter approval. Public Health Nurs 2011; 28:317-24. [PMID: 21736610 DOI: 10.1111/j.1525-1446.2011.00951.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare availability of emergency contraception in Iowa pharmacies, before and after the U.S. Food and Drug Administration (FDA) approved over-the-counter sales and identify reasons why over-the-counter, emergency contraception might still not be available in some Iowa pharmacies. DESIGN AND SAMPLE Secondary analysis of data collected for an existing, descriptive study. A total of 906 pharmacies were identified; 405 (56.8%) pharmacies participated before, and 308 (43.2%) after the FDA policy change. MEASURES Data collected via a scripted telephone survey. RESULTS After the FDA changed its policy and allowed over-the-counter sales of emergency contraception, the percentage of Iowa pharmacies offering emergency contraception increased from 57.8% to 70%. In the before sampling, 67.5% reported a perceived lack of demand as the primary reason for not carrying emergency contraception 66.7% reported this rationale in the after group. Other reasons included store policy, and moral, religious, or personal reasons. Pharmacists were surprisingly uninformed about the action of emergency contraception; before the FDA approved over-the-counter sales 53% believed the drugs primarily worked by blocking implantation of a fertilized egg. Indeed, even after FDA approved over-the-counter sales, 38% of pharmacists still believed that emergency contraception was comparable to an abortifacient. In addition, before the policy changed, 43.8% of pharmacists accepted emergency contraception as safe for teenagers; this percentage fell to 27.9% after the policy change. CONCLUSIONS Significant increases in the carrying of emergency contraception suggest the policy did succeed in increasing access. Despite this, barriers to access exist. Further research should explore why pharmacies might not carry emergency contraception.
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Farris KB, Ashwood D, McIntosh J, DiPietro NA, Maderas NM, Landau SC, Swegle J, Solemani O. Preventing unintended pregnancy: Pharmacists' roles in practice and policy via partnerships. J Am Pharm Assoc (2003) 2010; 50:604-12. [DOI: 10.1331/japha.2010.09195] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Davidson LA, Pettis CT, Joiner AJ, Cook DM, Klugman CM. Religion and conscientious objection: A survey of pharmacists’ willingness to dispense medications. Soc Sci Med 2010; 71:161-5. [DOI: 10.1016/j.socscimed.2010.03.027] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 03/08/2010] [Accepted: 03/15/2010] [Indexed: 11/29/2022]
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Sarkar NN. Barriers to emergency contraception (EC): does promoting EC increase risk for contacting sexually transmitted infections, HIV/AIDS? Int J Clin Pract 2008; 62:1769-75. [PMID: 19143861 DOI: 10.1111/j.1742-1241.2008.01827.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study was to focus on barriers, controversy and perceived risk associated with use of emergency contraception (EC) after unprotected sexual intercourse. DESIGN AND METHOD Data were extracted from the literature of the MEDLINE database service. Original articles, surveys, clinical trials and investigations are considered for this review. RESULTS After the introduction of over-the-counter and advance prescription provisions for easy access to EC, the rural-urban disparity in availability of EC poses a barrier to use of EC for rural dwellers. The socio-economically weaker section of the population is unable to purchase EC because of low or no income, although there is mounting pressure by the State for prevention of unintended pregnancy by use of EC. Some healthcare providers have objected to provide EC to the patient on the grounds of their conscience and morality. Some providers and users have also expressed concerns about the possibility of increase in irresponsible sexual behaviour because of easy access to EC. There may be some truth in their apprehension because nearly 3.2 million unintended pregnancies occur annually despite various contraceptive options available in USA and the extensive use of EC is directly proportional to the volume of unprotected sexual intercourse, which is too directly proportional to the quantum of risk for contacting sexually transmitted infections (STIs)/AIDS. CONCLUSIONS Emergency contraception is a one-off postcoital procedure and not to be opted after every sexual intercourse. Controversy about EC may be resolved if it is used within this limit. Extensive use of EC may increase risk for contacting STIs/AIDS.
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Affiliation(s)
- N N Sarkar
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India.
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Dunn S, Brown TER, Alldred J. Availability of emergency contraception after its deregulation from prescription-only status: a survey of Ontario pharmacies. CMAJ 2008; 178:423-4. [PMID: 18268268 DOI: 10.1503/cmaj.070861] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
In 2005 the emergency contraception formulation of levonorgestrel (Plan B) became available in Ontario pharmacies without a prescription. We surveyed 239 pharmacies 1 month before the regulatory change and 14-17 months after the change to determine whether availability of the drug increased. The response rates were 79% and 70% before and after the change in status. The proportion of pharmacies that had an in-stock supply of Plan B increased from 78% to 92% (p < 0.001). After the regulatory change, 87% of the surveyed pharmacies (95% confidence interval 82%-92%) reported that they had the drug in stock and were willing to dispense it behind the counter. Availability was similar for urban and rural pharmacies, but rural pharmacies had more restricted hours (e.g., 15% closed on weekends). Thus, as a result of the regulatory change, emergency contraception is more widely available, but access in rural areas is still limited by restricted pharmacy hours.
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El-Ibiary SY, Raine T, McIntosh J, Darney PD, Harper CC. Pharmacy access to emergency contraception: Perspectives of pharmacists at a chain pharmacy in San Francisco. J Am Pharm Assoc (2003) 2007; 47:702-10. [DOI: 10.1331/japha.2007.06127] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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