Exploring emergency contraception prescribing by pharmacists in California

Objective: To understand knowledge, current practices, barriers and facilitators for pharmacists prescribing emergency contraception (EC).

Study design: We conducted a cross-sectional survey among California community pharmacists. We distributed the online survey, consisting of 34 close-ended questions, to members of the California Pharmacists Association via its email listserve.

Results: We collected a survey response rate of 7%. Although 95% of respondents were aware of the statewide protocol allowing pharmacists to prescribe EC, only 36% of respondents reported prescribing EC in the previous year. Prescribing practices within the past year differed by type of pharmacy. We found no correlation between EC knowledge and prescribing practices. The most frequently reported facilitators of EC prescribing by pharmacists were the statewide protocol, a continuing education training program, and patient need or demand for EC. The most reported barriers to prescribing EC were lack of payment for pharmacist patient care services by insurers, increased responsibility or liability concerns, and time constraints. When asked about their intention to prescribe in the upcoming year, responses differed based on whether or not their pharmacies currently stocked EC.

Conclusion: This exploratory study identifies key facilitators, such as the statewide protocol, and key barriers, such as lack of payment by insurance companies for pharmacist services.

Implications: The findings of this study could guide future multi-component implementation strategies such as academic detailing that specifically address concerns about increased responsibility, liability and time constraints. In addition, payment for pharmacist services could be addressed at a policy level since this was a barrier to pharmacist EC prescribing.