That’s A Whole ‘Nother Ball Game: Community Pharmacists’ Perceived Benefits and Barriers to Prescribing Contraception in Appalachian Tennessee and Virginia

Authors' Affiliations

Amaranda Stokes, Department of Pharmacy Practice, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN; Dottie Smith, Department of Pharmacy Practice, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN; Mary Brannock, Department of Community and Behavioral Health, College of Public Health, East Tennessee State University, Johnson City, TN; Michelle Rapier, Department of Clinical Sciences, Fred Wilson School of Pharmacy, High Point University, High Point, NC

Location

D.P. Culp Center Ballroom

Start Date

4-5-2024 9:00 AM

End Date

4-5-2024 11:30 AM

Poster Number

27

Name of Project's Faculty Sponsor

KariLynn Dowling-McClay

Faculty Sponsor's Department

Pharmacy Practice

Classification of First Author

Clinical Doctoral Student

Competition Type

Competitive

Type

Poster Presentation

Presentation Category

Health

Abstract or Artist's Statement

Hormonal contraceptives are commonly used to prevent pregnancy, manage menstrual cycles, and meet other women’s health needs. However, access to reproductive health services remains inconsistent and in need of expansion. In the U.S., 26 states have implemented legislation allowing pharmacists to prescribe certain contraceptives to patients without requiring a visit to a doctor for a prescription. This advancement in pharmacy practice is potentially beneficial to patients seeking contraceptives but requires buy-in from pharmacists who would offer the service, an issue examined by researchers in this key informant interview study. Licensed community pharmacists working in Appalachian counties in Tennessee or Virginia were eligible for study inclusion. Directories of community pharmacies in the target counties were randomized and contacted for pharmacist recruitment. Interviews were scheduled using a scripted invitation, conducted via phone or an online platform, and audio recorded following verbal consent by participants. Semi-structured interview guides were used to determine participants’ knowledge, attitude, and beliefs about pharmacist prescribed contraception (PPC) in conversations lasting between 8 and 33 minutes. Each participant was given a $30 gift card following completion of the interview. Audio recordings were transcribed and de-identified using a professional transcription service. Responses were coded and thematically analyzed to determine pharmacists’ perceived benefits and barriers to offering PPC services. Nine Tennessee pharmacists and six Virginia pharmacists were interviewed. Ease of pharmacy access and convenience of PPC services were commonly described as benefits for patients. Several participants also perceived PPC as an innovation beneficial to the profession of pharmacy. Pharmacy work environment factors including time constraints, staffing and workflow challenges, finances, and lack of electronic health record integration were commonly identified as barriers to offering PPC. There was some variation in the perceived severity of these issues based on the type of pharmacy (retail chain or independent) the respondent worked in. In addition to work environment concerns, participants frequently described stress about adding tasks to their work responsibilities, fear of patient harm and liability issues, and discomfort related to offering PPC services. Most respondents were unprepared to offer PPC on the day of the interview and cited additional training as necessary to increase their comfort with PPC services. The findings suggest pharmacists in Appalachian Tennessee and Virginia may view PPC as a beneficial service for patients but are hesitant to participate due to work environment constraints, liability concerns, and inadequate training. If PPC is to be a feasible expansion of women’s health services in the Appalachian region, strategies to overcome these perceived barriers for community pharmacists should be prioritized.

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Apr 5th, 9:00 AM Apr 5th, 11:30 AM

That’s A Whole ‘Nother Ball Game: Community Pharmacists’ Perceived Benefits and Barriers to Prescribing Contraception in Appalachian Tennessee and Virginia

D.P. Culp Center Ballroom

Hormonal contraceptives are commonly used to prevent pregnancy, manage menstrual cycles, and meet other women’s health needs. However, access to reproductive health services remains inconsistent and in need of expansion. In the U.S., 26 states have implemented legislation allowing pharmacists to prescribe certain contraceptives to patients without requiring a visit to a doctor for a prescription. This advancement in pharmacy practice is potentially beneficial to patients seeking contraceptives but requires buy-in from pharmacists who would offer the service, an issue examined by researchers in this key informant interview study. Licensed community pharmacists working in Appalachian counties in Tennessee or Virginia were eligible for study inclusion. Directories of community pharmacies in the target counties were randomized and contacted for pharmacist recruitment. Interviews were scheduled using a scripted invitation, conducted via phone or an online platform, and audio recorded following verbal consent by participants. Semi-structured interview guides were used to determine participants’ knowledge, attitude, and beliefs about pharmacist prescribed contraception (PPC) in conversations lasting between 8 and 33 minutes. Each participant was given a $30 gift card following completion of the interview. Audio recordings were transcribed and de-identified using a professional transcription service. Responses were coded and thematically analyzed to determine pharmacists’ perceived benefits and barriers to offering PPC services. Nine Tennessee pharmacists and six Virginia pharmacists were interviewed. Ease of pharmacy access and convenience of PPC services were commonly described as benefits for patients. Several participants also perceived PPC as an innovation beneficial to the profession of pharmacy. Pharmacy work environment factors including time constraints, staffing and workflow challenges, finances, and lack of electronic health record integration were commonly identified as barriers to offering PPC. There was some variation in the perceived severity of these issues based on the type of pharmacy (retail chain or independent) the respondent worked in. In addition to work environment concerns, participants frequently described stress about adding tasks to their work responsibilities, fear of patient harm and liability issues, and discomfort related to offering PPC services. Most respondents were unprepared to offer PPC on the day of the interview and cited additional training as necessary to increase their comfort with PPC services. The findings suggest pharmacists in Appalachian Tennessee and Virginia may view PPC as a beneficial service for patients but are hesitant to participate due to work environment constraints, liability concerns, and inadequate training. If PPC is to be a feasible expansion of women’s health services in the Appalachian region, strategies to overcome these perceived barriers for community pharmacists should be prioritized.