Emergency Contraception Access and Counseling in Metropolitan and Nonmetropolitan Pharmacies in Georgia

2021 ◽  
pp. 089719002110528
Author(s):  
Rebecca H. Stone ◽  
Savannah Gross ◽  
Brielle Reardon ◽  
Henry N. Young
Keyword(s):  
Emergency Contraception ◽  
Geographic Location ◽  
Community Pharmacies ◽  
Patient Counseling ◽  
Chi Square ◽  
Ulipristal Acetate ◽  
Timely Access ◽  
Mystery Shopper ◽  
Stock Information ◽  
Work Up

Background: Emergency contraception (EC) efficacy is dependent on timing of administration. Adequate pharmacy stock information and accurate patient counseling are important to ensure timely access. Objective: This study evaluates pharmacist reported availability and counseling for levonorgestrel (LNG) and ulipristal acetate (UPA), and identifies differences between caller type and pharmacies in metropolitan vs nonmetropolitan areas of Georgia. Methods: This prospective, randomized, telephone-based study included 25% of Georgia community pharmacies, stratified by geographic location. Calls were made by investigators, first posing as a mystery shopper inquiring about EC stock and efficacy, then 3–6 weeks later as a researcher inquiring about EC stock. Analysis utilized descriptive statistics, chi Square, and logistic regression. Results: Of 600 pharmacies, the mystery shopper caller reached 86%: 74% of pharmacists initially discussed LNG, 57.1% had it stocked, more often in metropolitan areas (OR 1.7, 95% CI 1.08–2.6). Ulipristal acetate was discussed by 1.9% and reported in-stock < 1%. Of those who discussed window of efficacy, 79% indicated LNG would either not work 4 days after intercourse or they were unsure. The research caller successfully completed a second call for 64% of pharmacies: 57% stocked LNG, 3% stocked UPA, and UPA was more likely to be stocked in metropolitan pharmacies. Conclusion: In Georgia, UPA availability is poor, and nonmetropolitan pharmacies were less likely to stock LNG and UPA. A minority of pharmacists correctly indicated that LNG may work up to 120 hours after intercourse. Strategies are needed to overcome barriers to EC availability in community pharmacies and support pharmacists’ EC counseling.

scholarly journals Emergency Contraception Access and Counseling in Urban Pharmacies: A Comparison between States with and without Pharmacist Prescribing

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 105 ◽  
Author(s):  
Rebecca H. Stone ◽  
Sally Rafie ◽  
Dennia Ernest ◽  
Brielle Scutt
Keyword(s):  
Continuing Education ◽  
San Francisco ◽  
Emergency Contraception ◽  
Primary Source ◽  
Community Pharmacies ◽  
Patient Access ◽  
Patient Counseling ◽  
The Public ◽  
Adult Females ◽  
Primary Endpoints

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.

scholarly journals The content of patient counseling about interchangeable medicines and generic substitution in Finnish community pharmacies - a survey of dispensers

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Riikka Rainio ◽  
Riitta Ahonen ◽  
Johanna Timonen
Keyword(s):  
Reference Price ◽  
Quantitative Methods ◽  
Generic Substitution ◽  
Price System ◽  
Community Pharmacies ◽  
Patient Counseling ◽  
Chi Square ◽  
Reference Price System ◽  
Exact Test ◽  
Wide Range

Abstract Background Generic substitution aims to increase the use of more affordable generic preparations and restrain the growth of medicine expenditures. Pharmaceutical staff plays an important role in generic substitution by implementing substitution and counseling customers. The aim of this study was to explore how Finnish dispensers inform pharmacy customers about interchangeable medicines and generic substitution and what customers ask dispensers about generic substitution and the reference price system. Methods A questionnaire was sent to a random sample of dispensers (n = 1054) working in community pharmacies in spring 2018. The data was analyzed using frequencies, percentages and the Chi-square test and Fisher’s exact test. The open-ended questions were analyzed first using inductive content analysis and later with the quantitative methods mentioned above. Results The final study material consisted of 498 questionnaires (response rate 51%). The main topics dispensers always informed customers about were the physician’s record in the prescription not to substitute the medicine (69%) and that the prescribed or purchased interchangeable medicine did not belong in the reference price band (59%). Topics mentioned often by dispensers dealt with customer’s chance to choose their medicine from among several alternative products (68%) and the manufacturer of the interchangeable medicines (66%). Differences in appearance (33%) or in composition (28%) of interchangeable products were the most common topics mentioned only when the customer asked about them. Of the respondents 17.6% always and 51.4% often informed the customer about the least expensive interchangeable product at the point of dispensing. Customers’ questions about the generic substitution and reference price system most commonly (82.4%) concerned the similarity of interchangeable medicines. Conclusions Finnish dispensers provide customers with a wide range of information about different subjects when dispensing interchangeable medicines. Patient counseling generally meets the legislative requirements, except for price counseling. In future, information about generic substitution and interchangeable medicines should continuously be provided to customers both at pharmacies and elsewhere, e.g. through educational campaigns.

scholarly journals Emergency Contraception Counseling in California Community Pharmacies: A Mystery Caller Study

Pharmacy ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 38 ◽  
Author(s):  
Ditmars ◽  
Rafie ◽  
Kashou ◽  
Cleland ◽  
Bayer ◽  
...  
Keyword(s):  
San Francisco ◽  
Emergency Contraception ◽  
San Diego ◽  
Intrauterine Device ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Ulipristal Acetate ◽  
Contraception Counseling ◽  
Copper Intrauterine Device

This study was conducted to determine which emergency contraception (EC) methods are offered by community pharmacists in response to patient calls. Female mystery callers called all community pharmacies in two California cities using standardized scripts. The callers inquired about options available to prevent pregnancy after sex and whether that method was available at the pharmacy, using follow-up probes if necessary. A total of 239 calls were completed in San Diego (n = 127, 53%) and San Francisco (n = 112, 47%). Pharmacists indicated availability at most sites (n = 220, 92%) with option(s) reported as levonorgestrel only (LNG; n = 211, 88.3%), both ulipristal acetate (UPA) and LNG (n = 4, 1.6%), UPA only (n = 1, 0.4%), or non-specific EC (n = 4, 1.7%). Nineteen pharmacies (7.9%) did not have EC available on the day of the call. Following additional probing, some pharmacists discussed UPA (n = 49, 20.5%) or the copper intrauterine device (n = 1, 0.4%) as EC options. LNG EC products were available same-day in 90.1% of pharmacies, whereas UPA was available same-day in 9.6% of pharmacies. The majority of pharmacies called in this study offered and stocked at least one EC option, but the focus of discussions was on LNG and matched what was in stock and available.

20. Using a Mystery Shopper Approach to Assess Emergency Contraception Access in West Virginia Community Pharmacies

2020 ◽  
Vol 33 (2) ◽  
pp. 185-186
Author(s):  
Amie Ashcraft ◽  
Sara Farjo ◽  
Sarah Dotson ◽  
Charles Ponte ◽  
Usha Sambamoorthi ◽  
...  
Keyword(s):  
West Virginia ◽  
Emergency Contraception ◽  
Community Pharmacies ◽  
Mystery Shopper

Availability and Accuracy of Information Regarding Nonprescription Emergency Contraception

2016 ◽  
Vol 29 (5) ◽  
pp. 454-460 ◽  
Author(s):  
Katherine Kelly Orr ◽  
Virginia A. Lemay ◽  
Amanda P. Wojtusik ◽  
Margaret Opydo-Rossoni ◽  
Lisa B. Cohen
Keyword(s):  
Patient Education ◽  
Adverse Effects ◽  
Rhode Island ◽  
Emergency Contraception ◽  
Community Pharmacies ◽  
Exact Tests ◽  
Chi Square ◽  
Product Availability ◽  
Minimum Age ◽  
One Step

Background: Although access to emergency contraception (EC) has increased with nonprescription status and approval of Plan B One-Step without age restrictions, barriers may still remain in patient education. This study assesses product availability and accuracy of information for EC among community pharmacies in Rhode Island, comparing changes from 2009 to 2012. Methods: Two female investigators posing as patients seeking EC followed a standardized script over telephone conversations. Investigators assessed EC availability, product use information, and cost at all community (retail) pharmacies in Rhode Island. Data were reported as group results with no identifiers. Chi-square and Fisher exact tests were used to analyze results. Results: During spring of 2009 and 2012, 165 and 171 pharmacies were telephoned, respectively. Approximately 90% of pharmacies stocked EC both years. In all, 62% versus 28% ( P < .001) indicated EC should be taken as soon as possible; 82.5% versus 87.7% ( P = .220) provided correct administration information; 67% versus 84% ( P < .001) warned about adverse effects; and 67% versus 53% ( P = .123) provided the correct minimum age for purchase. Conclusions: Access to nonprescription EC in Rhode Island is very good. Sites not stocking EC should reassess plans for patients to obtain medication. There is need for reeducation on EC labeling to improve counseling provided over the telephone.

Preparing pharmacists to increase naloxone dispensing within community pharmacies under the Pennsylvania standing order

2020 ◽  
Author(s):  
Heather M Santa ◽  
Samira G Amirova ◽  
Daniel J Ventricelli ◽  
George E Downs ◽  
Alexandra A Nowalk ◽  
...  
Keyword(s):  
Community Pharmacists ◽  
The United States ◽  
Health Concern ◽  
Community Pharmacies ◽  
Opioid Overdose ◽  
Patient Counseling ◽  
Opioid Use ◽  
Overdose Prevention ◽  
Standing Order ◽  
Overdose Deaths

Abstract Purpose Opioid misuse and overdose deaths remain a public health concern in the United States. Pennsylvania has one of the highest rates of opioid overdose deaths in the country, with Philadelphia County’s being 3 times higher than the national average. Despite several multimodal interventions, including use of SBIRT (screening, brief intervention, and referral to treatment) methods and naloxone distribution, the rate of overdose deaths remains high. Methods To gain insights on strategies for improving access to naloxone and naloxone distribution by pharmacists in Philadelphia County, a study was conducted in 11 community pharmacies (chain and independent) in Philadelphia. Twenty-four pharmacists were recruited and completed SBIRT and naloxone trainings. Each pharmacy elected to have at least 1 pharmacy champion who received additional training on and helped develop pharmacy site–specific naloxone dispensing protocols. Results Pre-post survey results showed a reduction in stigmatizing attitudes regarding naloxone dispensing and an increase in pharmacists’ understanding of the standing order and appropriate naloxone use. There was an increase in pharmacists’ self-reported confidence in their ability to appropriately identify, discuss, and dispense naloxone to patients. All pharmacies increased their average monthly dispensing rate following protocol implementation. Conclusion Pharmacists who received both trainings were more likely to change naloxone dispensing practices, leading to an overall increase in naloxone dispensing by community pharmacists. The study addressed overall gaps in pharmacists’ knowledge, reduced stigma, and prepared pharmacists to address opioid use and overdose prevention with their patients. The described pharmacist-led patient counseling and intervention service for overdose prevention may be explored as a model for other community pharmacies to adopt to improve naloxone dispensing and similar interventions to reduce overdose deaths.

Current dispensing and practice use patterns of ulipristal acetate 30mg (Ella®), as emergency contraception in British Columbia, Canada

2020 ◽  
Vol 42 (5) ◽  
pp. 671
Author(s):  
Michelle Chan ◽  
Judith Soon ◽  
Laura Schummers ◽  
Sarah Munro ◽  
Parkash Ragsdale ◽  
...  
Keyword(s):  
British Columbia ◽  
Emergency Contraception ◽  
Ulipristal Acetate ◽  
Use Patterns

scholarly journals A PROSPECTIVE STUDY ON IMPACT OF PATIENT COUNSELLING ON QUALITY OF LIFE AND MEDICATION ADHERENCE IN EPILEPTIC PATIENTS

2016 ◽  
Vol 10 (1) ◽  
pp. 67
Author(s):  
Sathesh Kumar Sukumaran ◽  
Ayswarya P
Keyword(s):  
Quality Of Life ◽  
Medication Adherence ◽  
Patient Counseling ◽  
Chi Square ◽  
Patient Counselling ◽  
T Score ◽  
Epileptic Patients ◽  
A Prospective Study ◽  
The Impact

ABSTRACTObjective: To study the impact of patient counseling on medication adherence and quality of life (QOL) in epileptic patients and to assess the factorsaffecting medication adherence.Methods: This study is a prospective observational study involving 100 patients with an age limit of 8-60 years and those taking Antiepilepticdrugs for at least 3 months. The study population received patient counseling during their first visit. The impact of patient counseling on QOL andmedication adherence was assessed using self-reported questionnaire QOLIE-31 and MMAS-8 between the first visit and the second visit. Statisticalanalysis (Paired t-test and Paired Chi-square test) was performed to analyze the impact of patient counseling on QOL and medication adherence inepileptic patients.Results: A total of 100 patients were included in the study. After providing patient counseling, it was observed that there was a statistically significant(p<0.05) improvement in all domains of QOLIE-31 and MMAS-8 scores. Before counseling, mean overall T-score of QOLIE-31 was 44.08±2.07whichwas changed to 49.14±1.27 after patient counseling with a mean change of 5.06 in overall T-score. In the case of medication adherence, beforecounseling 77% subjects were nonadherent to therapy, after counseling it was reduced to 41%. The common reasons for medication adherence wereforgetfulness, unawareness, therapy related, and economics related. Out of which forgetfulness along with unawareness was the major one.Conclusion: The study described that patient counseling plays a major role in improving QOL and medication adherence.Keywords: QOLIE-31, MMAS-8, Epilepsy, Antiepileptic drugs, Patient counseling.

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