4.6 Article

Pharmacist direct dispensing of mifepristone for medication abortion in Canada: a survey of community pharmacists

期刊

BMJ OPEN
卷 12, 期 10, 页码 -

出版社

BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2022-063370

关键词

SEXUAL MEDICINE; REPRODUCTIVE MEDICINE; PRIMARY CARE; PUBLIC HEALTH; Medical abortion; Pharmacy practice

资金

  1. Canadian Institutes of Health Research, Partnerships for Health System Improvement grant [PHE148161]
  2. Michael Smith Foundation for Health Research [16743, 18270, 2012-5139]
  3. Canadian Institutes of Health Research [CPP-329455-107837]
  4. Canadian Institutes of Health Research (CIHR)
  5. UBC Killam Doctoral Scholarship

向作者/读者索取更多资源

A survey conducted among community pharmacists in Canada found that the majority of pharmacists were willing and ready to dispense mifepristone, with few barriers reported in terms of stocking or dispensing the medication. The implementation of the policy to allow pharmacists to directly dispense mifepristone has facilitated medication abortion in primary care settings.
Introduction Pharmacists were acknowledged as the most appropriate healthcare professional to dispense mifepristone for medication abortion shortly after the prescription therapy became available in January 2017 in Canada. Objective We aimed to identify the facilitators and barriers for successful initiation and ongoing dispensing of mifepristone among community pharmacists across Canada. Study design We surveyed community pharmacists from urban/rural practice settings across Canada by recruiting from January 2017 to January 2019 through pharmacist organisations, professional networks, at mifepristone training courses and at professional conferences. The Diffusion of Innovations theory informed the study design, thematic analysis and interpretation of findings. We summarised categorical data using counts and proportions, chi(2) tests, Wilcoxon rank-sum and proportional odds logistic regression. Results Of the 433 responses from dispensing community pharmacists across 10/13 Canadian provinces and territories, 93.1% indicated they were willing and ready to dispense mifepristone. Key facilitators were access to a private consultation setting (91.4%), the motivation to increase accessibility for patients (87.5%) and to reduce pressure on the healthcare system (75.3%). The cost of the mifepristone/misoprostol product was an initial barrier, subsequently resolved by universal government subsidy. A few pharmacists mentioned liability, lack of prescribers or inadequate stock as barriers. Conclusions Pharmacist respondents from across Canada reported being able and willing to dispense mifepristone and rarely mentioned barriers to stocking/dispensing the medication in the community pharmacy setting. The removal of initial regulatory obstacles to directly dispense mifepristone to patients facilitated the provision of medication abortion in the primary care setting.

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