Implementation of pharmacy access to hormonal contraception
Awarded 2021
Complex Family Planning Fellowship Research
Lindsay Dale, MD
University of New Mexico

Background: Twelve U.S. states and the District of Columbia have authorized independent pharmacist prescribing of hormonal contraception, allowing facilitated access and initiation of contraception at the pharmacy.1 Multiple barriers to pharmacists’ uptake of hormonal contraception prescribing include the need for additional pharmacy staff, required training/education, and lack of reimbursement processes/billing structures. 2 ??4 States lack adequate guidance for successful implementation of pharmacist prescribing; their experience and “lessons learned ” may benefit future implementation efforts.

Objective: This study will explore implementation of pharmacy access to hormonal contraception in the 12 U.S. states and District of Columbia with independent pharmacist prescriptive authority. The primary objective is to describe, using an implementation framework, the steps states have taken to enable pharmacist prescription of hormonal contraception. Secondary objectives include a comparison of different states’ perceived barriers and solutions, and determinants of successful program implementation.

Design and Methods: In this qualitative study, we will conduct semi-structured interviews with representatives from state pharmacist associations, community pharmacists and Medicaid offices of the 12 U.S. states and District of Columbia that have authorized pharmacists to prescribe contraception. Interviews will explore state-level program implementation, including steps taken, facilitators of success, perceived barriers and potential solutions. We will organize data through an implementation framework and analyze data using qualitative content analysis principles.
Potential Impact: In describing the steps of states’ implementation strategies, we anticipate synthesizing vital information to assist future states’ efforts to overcome barriers, increasing uptake and availability of pharmacist prescribing of hormonal contraception.