We wish to assess the feasibility of community pharmacists directly initiating and managing hormonal contraceptive methods for women through use of collaborative drug therapy agreements (CDTA) in a pilot study, and then to expand the demonstration to measure its effectiveness with a larger number of women in more pharmacies on the basis of the pilot data. Despite the fact that 93% of women at risk of pregnancy in the United States use some form of contraception, unintended pregnancies nonetheless represented nearly half of all pregnancies occurring to American women in 1995. Recommendations of the Committee on Unintended Pregnancy writing for the Institute of Medicine urged increasing access to contraception through broadening the range of health professionals that provide birth control. Emergency contraceptive pills (ECP) are efficiently provided by community pharmacists and women report satisfaction with the direct access. However, ongoing effective contraception currently requires a clinic visit and many women purchasing less effective over-the-counter (OTC) methods could benefit from increased choices, such as hormonal methods. If women will accept and effectively use hormonal contraceptives obtained from a community pharmacist, and if pharmacists can provide appropriate hormonal contraceptive screening and monitoring as sustainable, reimbursable activities within their practices, women could gain a new choice or venue to prevent unintended pregnancy.
|Gardner, Jacqueline S; Miller, Leslie; Downing, Donald F et al. (2008) Pharmacist prescribing of hormonal contraceptives: results of the Direct Access study. J Am Pharm Assoc (2003) 48:212-21;5 p following 221|
|Memmel, Lisa M; Miller, Leslie; Gardner, Jacqueline (2006) Over-the-internet availability of hormonal contraceptives regardless of risk factors. Contraception 73:372-5|
|Shotorbani, Solmaz; Miller, Leslie; Blough, David K et al. (2006) Agreement between women's and providers' assessment of hormonal contraceptive risk factors. Contraception 73:501-6|