The Acceptability of Contraception Task-sharing Among Canadian Pharmacists: The ACT-Pharm Study
ESC Congress Library. Norman W. May 28, 2014; 50618; A-203 Disclosure(s): none
Dr. Wendy V. Norman
Dr. Wendy V. Norman
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Objectives: Access to prescription contraceptives in rural areas is often limited by the hours and location of physician or youth clinic services. Pharmacists are trusted, available professionals. This study aimed to explore the acceptability and feasibility for independent provision of contraception by pharmacists in rural British Columbia (BC), Canada.

Methods: This mixed methods study mailed surveys to all 333 rural pharmacies in BC, as well as to a purposive cluster-randomized sample of 32 urban pharmacies near Vancouver (August-October 2012) with fax and telephone reminders at one month. Participants were invited to a structured telephone interview. Questions followed Rogers Diffusion of Innovations theory, were reviewed by a panel of experts and refined by focus group and pilot testing among community pharmacists.

Results: Among 374 invited community pharmacies 145 (38.8%) responded, including 127 of 333 (38.1%) rural and 15/42 (35.7%) of invited urban community pharmacies. Nearly half (49%) of responding pharmacies volunteered for interviews, among whom 17 rural and 2 urban respondents were interviewed. Respondents represented the five geographic health authority regions of BC, were half (74/142) male, one-quarter (95/142) managers or owner-pharmacists, and reported a mean of 16 years in practice. Seventy percent of rural (53% of urban) pharmacies reported a private counselling area. Over 84% (107/127) of rural pharmacists indicated interest to prescribe hormonal contraceptives. Factors associated through logistic regression with willingness to prescribe were: comfort using a protocol, presence of a confidential counselling room, certification in special skills such as immunization, and fewer years in practice. Pharmacists indicated a need to clearly understand assessment protocols and liability issues, prior to implementation.


Conclusion: Pharmacists in rural BC, Canada, report a high degree of acceptability and feasibility for independent prescription of hormonal contraceptives. As pharmacists are often the most accessible health professional in rural areas, pharmacist provision of hormonal contraceptives carries the potential to improve timely access to contraception.

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