Home Pharmacy practice ETSU to study the availability of birth control | New

ETSU to study the availability of birth control | New

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JOHNSON CITY – Dr. KariLynn Dowling-McClay, Assistant Professor of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy, has received a grant of $ 11,998 from the Research Development Committee (DRC) of the ETSU to study pharmacist-prescribed contraception (PCP) as a way to bridge the gap in regional access to birth control in the Appalachians and the southern United States

“This is a nationwide problem with nearly half of all pregnancies in the United States being unplanned or ‘surprise’ pregnancies each year,” said Dr. Dowling-McClay. “If a pregnancy occurs when it is not planned, the risks to the mother, baby and family are greater. Constant access to effective contraceptive methods is the best way to prevent unplanned pregnancies.

The need for consistency runs into additional issues in the Appalachians, according to Dowling-McClay, including: distance to clinics, lack of transportation, lack of health insurance, misinformation about reproductive health, poor health awareness, mistrust of provider beliefs, all of which have been shown to reduce access to birth control. While emphasizing that the list is not exhaustive, Dowling-McClay believes there is a way to narrow this access gap by using PPC.

“Pharmacist-prescribed contraception is a healthcare innovation that could fill a gap in access to birth control for women who need it most,” she added. “It is also an opportunity for pharmacists to fulfill their duty to preserve and improve the health of the population. We want to know if this service is feasible and desired in the Appalachian region from the perspective of women, pharmacists and other health care providers.

CPPs are provided in a retail pharmacy. For patients, this means sitting down with a pharmacist for a brief assessment and walking out with a prescription, written and filled by the pharmacist, for contraceptive drugs.

“In states that allow CPAP, pharmacists can generally prescribe any type of contraception except intrauterine devices and arm implants which both require medical procedures,” said Dowling-McClay. . “Depending on the insurance coverage available, if any, the patient may pay for the drug and / or consultation fees for the pharmacist’s service. This is different from the traditional model where a patient would go to their doctor’s office, often requiring an appointment weeks or even months in advance, and received a prescription for contraception that they would then take to their pharmacy to be. executed.

The potential benefits of PPC include: increased access, convenience, and affordability. An integrated screening process identifies women with serious medical conditions who should remain under the care of a regular physician.

Dowling-McClay chose Tennessee and Virginia as the focus of his study, as both are places where PPC is permitted by state law, but in different ways regarding how the service may be offered. . For example, Tennessee requires a Collaborative Practice Agreement (CPA), a document signed by a pharmacist and doctor, which delegates certain tasks to the pharmacist that they would not be able to do otherwise; Virginie does not have this prerequisite.

“This led to our selection of these two states as the focus of our study,” said Dr. Dowling-McClay. “We want to understand how the different policies of the two states can make it easier or more difficult for pharmacists to set up CPD services and, therefore, make it easier or more difficult for women to access these services.”

In Tennessee, a pharmacist must find a local prescriber willing to sign a CPA and authorize them to prescribe contraception. Virginia, however, has published a statewide protocol allowing pharmacists to prescribe contraceptives without CPA.

“A licensed pharmacist in Virginia can do this right now with no paperwork or additional signatures required. That’s why we’re interested in comparing how things are currently looking for PPC in Tennessee and Virginia, ”said Dowling-McClay. “As far as we know, very few pharmacies in Tennessee have initiated PPC programs within the three years they have been licensed. Virginia is even earlier in the process, which makes it a good time to identify potential challenges. “

Dr Michael G. Smith, Assistant Professor at the ETSU College of Public Health and Director of Programs and Policy at the ETSU Center for Applied Research and Evaluation in Women’s Health (CARE Women’s Health), will work with Dr Dowling- McClay on PPC research. .

“Difficulty accessing contraceptive advice and methods continues to be a barrier to empowering women, partners and families to match their reproductive experiences with their plans and desires,” Smith added. “We want to understand whether the ability to access contraceptive advice and methods in a pharmaceutical setting is something that people in central Appalachia want, if pharmacists in that region believe that policies that allow CFCs to respond to needs of their patients and whether traditional providers of contraceptive care support by working with their fellow pharmacists to extend the supply of care to pharmacies. In the long term, we hope that this research will result in more people shouting “yes” when they find out they are pregnant and fewer saying “what are we going to do” when they find out they are pregnant. . “

In addition to logistical considerations such as space, time, cost and advertising, Dr Dowling-McClay said pharmacists need to find ways to make the service financially viable, and pointed out that many of them may feel insufficiently prepared to participate after attending school before CPD is an option. She also noted a lack of information on demand for CPD from women in the region, or what primary health care and women’s health providers think of pharmacists potentially offering this service.

“Exploring all of these factors specific to Appalachia will help us identify possible solutions that meet the needs of women in the region,” she said. “Ideally, we can expand our research to the rest of the Appalachian region or nationwide. Our results may have implications for state policies regarding pharmacists’ scope of practice and access to contraception. In the long term, we hope that the work started in this project will contribute to better access to contraception, a decrease in the number of unintended pregnancies and an increase in family planning.


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