Abstract
Adolescent pregnancy is an important public health issue, and pharmacist prescribing has the potential to expand contraceptive access and decrease unintended pregnancy. However, little is known about acceptability and uptake of pharmacist prescribing among adolescents, particularly among youth in socially and politically conservative regions of the country. The study objective was to identify how young women in Indiana perceive pharmacist contraceptive prescribing. Participants were recruited from clinics and completed a simulated pharmacist contraception-prescribing encounter; a demographic and behavioral questionnaire; and an in-depth qualitative interview focused on adolescent perspectives on pharmacist prescribing. Data were analyzed using thematic analysis. Sixty young women aged 14–21 years (mean age 17.0 ± 1.7 years) completed in-depth interviews. The majority expressed interest in pharmacist contraceptive prescribing (n = 33, 55.9%). Three overarching themes were identified, focusing on accessibility; quality of care; and pharmacist knowledge and youth friendliness. Subthemes highlighted the need for improved confidential access; a desire for additional pharmacist training in contraception; and interactions with a pharmacist that can relate to the young person. Increased awareness of the perceptions of young people can inform state policies and pharmacy protocols. Pharmacists, because of their accessibility, are well poised and equipped to assist in this public health concern.
Highlights
Access to contraception is a key strategy to reduce adolescent unintended pregnancy
The only differences between participants with and without chronic illness were that participants with chronic illness were less likely to report diverse ethnicities (20% vs. 93%, p < 0.05), more likely to report private insurance (87% vs. 13%, p < 0.05), and more likely to report a medical contraindication to contraception (27% vs. 17%, p < 0.10)
Related to pharmacist contraceptive prescribing, young people expressed concerns related to confidentiality and privacy in the standard community pharmacy environment
Summary
Access to contraception is a key strategy to reduce adolescent unintended pregnancy. Pharmacist contraceptive prescribing is an innovative, but under-used, way to increase contraceptive access.Despite national declines in unintended pregnancies, adolescents aged 15–19 have the highest rates, with three out of four pregnancies in this age group unplanned [1]. Access to contraception is a key strategy to reduce adolescent unintended pregnancy. Pharmacist contraceptive prescribing is an innovative, but under-used, way to increase contraceptive access. Adolescents may have limited access to primary care or women’s health services and may be unable to obtain a prescription for contraception [2]. Barriers to accessing contraception are greater the younger the adolescent is and for those with low incomes [2,3,4]. These barriers include lack of affordability or insurance, transportation, privacy concerns, and medical providers that are unwilling or unable to provide contraceptive services [2,3,4]. Difficulty accessing preventative services such as contraception can lead to increased healthcare costs and innovative ways to expand access are needed [4]
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