Abstract
Pharmacists are often the primary source of emergency contraception (EC) access and patient information. This study aims to identify differences in pharmacist-reported EC access and counseling between states which do or do not permit pharmacist-prescribed EC. This prospective, mystery caller study was completed in California (CA), which permits pharmacist-prescribed EC after completion of continuing education, and Georgia (GA), which does not. All community pharmacies that were open to the public in San Diego and San Francisco, CA, and Atlanta, GA were called by researchers who posed as adult females inquiring about EC via a structured script. Primary endpoints were EC availability and counseling. Statistical analyses completed with SPSS. Researchers called 395 pharmacies, 98.2% were reached and included. Regarding levonorgestrel (LNG), CA pharmacists more frequently discussed (CA 90.4% vs. GA 81.2%, p = 0.02), stocked (CA 89.5% vs. GA 67.8%, p < 0.01), and correctly indicated it “will work” or “will work but may be less effective” 4 days after intercourse (CA 67.5% vs. GA 17.5%, p < 0.01). Ulipristal was infrequently discussed (CA 22.6% vs. GA 3.4%, p < 0.01) and rarely stocked (CA 9.6% vs. GA 0.7%, p < 0.01). Pharmacists practicing in states which permit pharmacist-prescribed EC with completion of required continuing education may be associated with improved patient access to oral EC and more accurate patient counseling.
Highlights
There are three types of emergency contraception (EC) available in the United States: insertion of the copper intrauterine device (Cu-IUD), an over the counter levonorgestrel (LNG) 1.5 mg oral tablet, and a prescription-only ulipristal acetate (UPA) 30 mg oral tablet [1].The Cu-IUD is used off-label for EC and is the most effective method available; compared to oral EC methods, it is infrequently used, likely due to issues surrounding timely access and lack of patient and provider awareness [2]
Ulipristal acetate was FDA-approved as a prescription-only medication in 2010
Ulipristal acetate is more effective than LNG at preventing pregnancy in some situations, Pharmacy 2020, 8, 105; doi:10.3390/pharmacy8020105
Summary
There are three types of emergency contraception (EC) available in the United States: insertion of the copper intrauterine device (Cu-IUD), an over the counter levonorgestrel (LNG) 1.5 mg oral tablet, and a prescription-only ulipristal acetate (UPA) 30 mg oral tablet [1].The Cu-IUD is used off-label for EC and is the most effective method available; compared to oral EC methods, it is infrequently used, likely due to issues surrounding timely access and lack of patient and provider awareness [2]. There are three types of emergency contraception (EC) available in the United States: insertion of the copper intrauterine device (Cu-IUD), an over the counter levonorgestrel (LNG) 1.5 mg oral tablet, and a prescription-only ulipristal acetate (UPA) 30 mg oral tablet [1]. Oral LNG was the first dedicated progestin-only EC pill, and was approved by the FDA in 1999 as a two 0.75 mg dose regimen and required a prescription [3]. Over time, it was formulated as a single 1.5 mg dose regimen and approved over the counter for individuals. Ulipristal acetate is more effective than LNG at preventing pregnancy in some situations, Pharmacy 2020, 8, 105; doi:10.3390/pharmacy8020105 www.mdpi.com/journal/pharmacy
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