More than 19 million women in the US live in a contraceptive desert1— areas with inadequate access to all types of contraceptive methods. This burden disproportionately affects women of color.2 They also tend to report more negative healthcare experiences overall.3 One promising policy reform to address this crisis is to expand the prescribing powers of pharmacists to allow them to both prescribe and dispense selected contraceptives. However, there are common implementation challenges that policy makers need to be aware of and address.
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The Challenge: Awareness and Transparency
A common barrier to widespread implementation of pharmacist prescribing is lack of awareness due to the lack of strong outreach and communication strategies to disseminate new policy information. To address this, policy makers may wish to consider taking the following actions:
- Create a robust alert and notification system to raise awareness of new policies and laws. Such as email alerts and notices with printable informational flyers and a copy of the new policy.
- Create a published, readily accessible list of all pharmacists and pharmacies Certified to prescribe and dispense hormonal contraceptives.
The Challenge: Training and Continuing Education
Training programs and continuing education initiatives are essential to the successful implementation of policies that address people’s needs. Training helps pharmacists acquire or expand their knowledge of hormonal contraception. This includes how to assess an individual’s eligibility, how to communicate and deliver contraceptive counseling, and how to assess what operational changes and practices need to be implemented to meet state standards. included. While not an exhaustive list, these components are important for implementing contraceptive prescriptions by pharmacists. As the power and role of pharmacists expand, another factor that is often overlooked is ensuring that pharmacists are incentivized to complete their training through continuing education credits and other means of compensating time.
States can effectively implement training programs by:
- Create an implementation working group or other interdisciplinary task forces to oversee and support implementation and issue training guidance.
- Develop accreditation standards and encourage pharmacists to complete continuing education on statewide protocolsStates may wish to consider other training models to inform the development of prescription training for pharmacists.
Challenge: Billing and Refunds
Another concern is that pharmacists cannot be reimbursed by insurance companies and health benefit plans for the extra effort and protocol required to prescribe contraceptives. Similar concerns have arisen in states that have increased access to contraception through year-long prescriptions. To address these concerns, states should:
- development of billing guidance for pharmacists, as they provide an increasingly important care service, It also trains pharmacists on this billing guidance.
- Make sure your policy clearly calls for reimbursement of time spent and services provided. Including contraceptive counseling.
- Development and implementation of billing codes for pharmacists, if it applies.
Read more about promoting access to contraception in previous reports in this series
The Challenge: Patient Privacy and Confidentiality
Another concern is whether pharmacies have the space and ability to provide patients with the necessary confidentiality to comply with state and federal privacy standards. This is important to protect sensitive patient health information and ensure that patients consent to treatment and are comfortable. States must:
- Configure pharmacy spaces to create private areas where patients can receive counseling Discuss other safeguards with the pharmacist.
The Challenge: Safety and Responsibility of Pharmacists
Finally, there are concerns about patient safety and pharmacist liability. Certain medical conditions can make hormonal contraceptives inappropriate or unsafe. This is known as a contraindication. There are concerns that people may be inappropriately prescribed hormonal contraceptives without proper and thorough physical examination by pharmacists or full disclosure of medical history from patients. To do so, pharmacists, like other health care providers, should:
- Conduct necessary patient screening and evaluationIncluding blood pressure screening, before prescribing hormonal contraceptives.
Expanding pharmacists’ prescribing powers is an important policy option that can reduce barriers to access to contraceptives. Effective and widespread pharmacist prescribing of contraceptives helps ensure women’s right to decide when to have children and when not to have children, and promotes physical and reproductive autonomy. It might help.Policy makers can look to some of the states mentioned in the full reportFour As a model of how to initiate and design a program appropriately tailored to the needs of each state.