Physicians' Opinion Regarding Extended Access to Hormonal Contraception in Switzerland.

Tamara Yous,Samuel Allemann,Monika Lutters

doi:10.3390/pharmacy9040184

Abstract

(1) Background: Access to hormonal contraceptives (HC) strongly differs between countries and varies from over the counter (OTC) to prescription-only availability. This study aimed to identify opinions among physicians in Switzerland regarding extended access to HC. (2) Methods: Web-based survey among physicians (gynecologists, general practitioners, and pediatricians) in Switzerland. (3) Results: Hundred sixty-three physicians, mainly gynecologists, participated in this survey and 147 (90%) were included for analysis. A total of 68% (n = 100) answered that prescription-only status could be extended under certain conditions but physicians were concerned about patients’ safety (97%, n = 142). Moreover, there was concern about insufficient patient education on HC (93%, n = 136) and that women may forego preventive examinations (80%, n = 118). Participants did not support OTC availability (93%, n = 136). Pharmacists prescribing (including initiation of HC) revealed controversial results, but a combined access model (initial prescription from physician and follow-up prescriptions by pharmacists) found acceptance in 70% (n = 103). (4) Conclusions: Participating physicians stated that prescription-only status for HC could be lifted under certain conditions but also some concerns, e.g., patients’ safety or neglection of preventive examinations, were raised. Future research should focus on specific conditions in which extended access to HC could be agreed on.

Highlights

Over 60 years ago, the first combined oral contraceptive named Enovid® has been approved by the FDA [1]
(4) Conclusions: Participating physicians stated that prescription-only status for hormonal contraceptives (HC) could be lifted under certain conditions and some concerns, e.g., patients’ safety or neglection of preventive examinations, were raised
Our survey revealed a clear refusal of over the counter (OTC) access to HC, which corresponds to the view among pharmacists in Switzerland [19]

Summary

Introduction

Over 60 years ago, the first combined oral contraceptive named Enovid® has been approved by the FDA [1]. Kennedy et al showed in a recent review that women and providers generally supported extended access, meaning access without prescription from a physician [3]. Prescription status remained unchanged in the United States of America (USA) but many states allow trained pharmacists to offer contraception service and directly provide HC in community pharmacies [4]. New Zealand has recently reclassified selected HC to allow supply by pharmacists, but first-time users and women aged less than 16 years are excluded [8,9]. In Europe, a study from the United Kingdom (UK) demonstrated that trained community pharmacists provided appropriate oral contraception service and that the pharmacy is a feasible site to provide HC [10]. Progesterone-only pills (POP) have been reclassified in the UK and women can obtain them from pharmacies without prescription [11]

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