TY - JOUR
T1 - Association of pharmacist prescription and 12-month contraceptive continuation rates
AU - Rodriguez, Maria I.
AU - Skye, Megan
AU - Edelman, Alison B.
AU - Anderson, Lorinda
AU - Darney, Blair G.
N1 - Funding Information:
This study was funded by a grant from Arnold Ventures. REDcap through Oregon Health & Science University was used for this study, and as such, this research was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR0002369. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Neither funder was involved in study design, data collection, analysis, or write up.
Funding Information:
M.I.R. reported receiving grants from Arnold Ventures during the conduct of the study, grants from the National Institute on Minority Health and Health Disparities , personal fees from the American Congress of Obstetricians and Gynecologists , and personal fees from Merck and Bayer outside the submitted work. A.B.E. reported receiving grants from Merck, research monies from HRA Pharma, and author royalties from UpToDate and serving as a consultant for the World Health Organization , the Centers for Disease Control and Prevention , Gynuity Health Projects, FHI 360, and Nexplanon and as a trainer for Merck (with all honoraria declined since 2016) outside the submitted work. L.A. reported receiving speaker honoraria from the American Society of Health-System Pharmacists. B.G.D. reported receiving grants where she is the principal investigator from Merck and the Office of Populations Affairs. No other disclosures were reported.
Funding Information:
M.I.R. reported receiving grants from Arnold Ventures during the conduct of the study, grants from the National Institute on Minority Health and Health Disparities, personal fees from the American Congress of Obstetricians and Gynecologists, and personal fees from Merck and Bayer outside the submitted work. A.B.E. reported receiving grants from Merck, research monies from HRA Pharma, and author royalties from UpToDate and serving as a consultant for the World Health Organization, the Centers for Disease Control and Prevention, Gynuity Health Projects, FHI 360, and Nexplanon and as a trainer for Merck (with all honoraria declined since 2016) outside the submitted work. L.A. reported receiving speaker honoraria from the American Society of Health-System Pharmacists. B.G.D. reported receiving grants where she is the principal investigator from Merck and the Office of Populations Affairs. No other disclosures were reported.This study was funded by a grant from Arnold Ventures. REDcap through Oregon Health & Science University was used for this study, and as such, this research was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR0002369. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Neither funder was involved in study design, data collection, analysis, or write up.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/12
Y1 - 2021/12
N2 - Background: States have passed legislation to expand the scope of pharmacists to directly prescribe contraception. It is thought that pharmacist prescription of contraception may promote correct and consistent use of contraception by reducing barriers to access. However, it is not known how this may impact ongoing contraceptive use. Objective: This study aimed to determine whether 12-month rates of continuation of an effective form of contraception or perfect use of contraception differ by prescribing provider (pharmacist or clinician). Study Design: We conducted a 1-year prospective cohort study of 388 women seeking contraception in 139 pharmacies across 4 states (California, Colorado, Hawaii, and Oregon). Our study was powered to detect a 10% difference in 12-month continuation of an effective form of contraception. We clarified women's pregnancy intention at baseline and subsequent follow-ups. Women received a prescription directly from a pharmacist (n=149) or were filling a prescription from a clinician, our comparison group (n=239). We used multivariable logistic regression to measure the association between pharmacist prescriber and use of any effective contraceptive method or perfect use at 12 months. Model covariates included age, race, education, side effects experienced, payor, and contraceptive supply dispensed at baseline. Results: Of the study cohort, 88% (n=340) completed 12 months of follow-up. Among women not planning to become pregnant, 7 women in the clinic-prescribed group vs 1 woman in the pharmacy-prescribed group (3.4% vs 0.8%; P>.05) reported a positive pregnancy test during the study period. The majority of the cohort was continuing to use an effective method of contraception at 12 months (clinician 89.3% vs pharmacist 90.4%; P=.86). Among women receiving a prescription from a clinician, 53.9% reported perfect use (no missed days) at 12 months, compared with 47% of the pharmacist-prescribed group (P=.69). Pharmacist prescriber type was not associated with continuation of an effective contraceptive method at 12 months (adjusted odds ratio, 0.70; confidence interval, 0.28–1.71) or with perfect use of contraception (adjusted odds ratio, 0.87; confidence interval, 0.51–1.48), controlling for other woman-level characteristics. Conclusion: We found no difference in use of any effective contraception, perfect use, or switching at 12 months among those who received their baseline prescription from a pharmacist vs a clinician. This study is limited by not examining information on safety outcomes.
AB - Background: States have passed legislation to expand the scope of pharmacists to directly prescribe contraception. It is thought that pharmacist prescription of contraception may promote correct and consistent use of contraception by reducing barriers to access. However, it is not known how this may impact ongoing contraceptive use. Objective: This study aimed to determine whether 12-month rates of continuation of an effective form of contraception or perfect use of contraception differ by prescribing provider (pharmacist or clinician). Study Design: We conducted a 1-year prospective cohort study of 388 women seeking contraception in 139 pharmacies across 4 states (California, Colorado, Hawaii, and Oregon). Our study was powered to detect a 10% difference in 12-month continuation of an effective form of contraception. We clarified women's pregnancy intention at baseline and subsequent follow-ups. Women received a prescription directly from a pharmacist (n=149) or were filling a prescription from a clinician, our comparison group (n=239). We used multivariable logistic regression to measure the association between pharmacist prescriber and use of any effective contraceptive method or perfect use at 12 months. Model covariates included age, race, education, side effects experienced, payor, and contraceptive supply dispensed at baseline. Results: Of the study cohort, 88% (n=340) completed 12 months of follow-up. Among women not planning to become pregnant, 7 women in the clinic-prescribed group vs 1 woman in the pharmacy-prescribed group (3.4% vs 0.8%; P>.05) reported a positive pregnancy test during the study period. The majority of the cohort was continuing to use an effective method of contraception at 12 months (clinician 89.3% vs pharmacist 90.4%; P=.86). Among women receiving a prescription from a clinician, 53.9% reported perfect use (no missed days) at 12 months, compared with 47% of the pharmacist-prescribed group (P=.69). Pharmacist prescriber type was not associated with continuation of an effective contraceptive method at 12 months (adjusted odds ratio, 0.70; confidence interval, 0.28–1.71) or with perfect use of contraception (adjusted odds ratio, 0.87; confidence interval, 0.51–1.48), controlling for other woman-level characteristics. Conclusion: We found no difference in use of any effective contraception, perfect use, or switching at 12 months among those who received their baseline prescription from a pharmacist vs a clinician. This study is limited by not examining information on safety outcomes.
KW - contraception
KW - contraceptive continuation
KW - hormonal contraception
KW - pharmacists
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U2 - 10.1016/j.ajog.2021.06.089
DO - 10.1016/j.ajog.2021.06.089
M3 - Article
C2 - 34217725
AN - SCOPUS:85110640064
SN - 0002-9378
VL - 225
SP - 647.e1-647.e9
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 6
ER -