| Abstrakt: |
Introduction: A public health initiative in the United States is to lower the country's 45% unintended pregnancy rate. Although pharmacist‐prescribed contraception is beneficial, implementation is low. Enhancing motivators and overcoming barriers could increase implementation. Objectives: To quantify the motivating factors and barriers to pharmacist‐prescribed contraception and compare them by interest in implementing contraception prescribing. Methods: The Theoretical Domains Framework was used to create an investigator‐developed 41‐item survey. Surveys were mailed to all Michigan independent pharmacies and chain pharmacies granting permission. Descriptive and nonparametric analyses were conducted. Results: Survey response rate was 11% (N = 147). Pharmacies were independent (39.5%), small independent group (2‐4 stores, 21.8%), large independent group (≥5 stores, 8.8%), national chain (15%), and two grocery store chains (15%). Top motivators to implement this service were to increase scope of practice, patient access to contraception, and pharmacy revenue. Top pharmacist, financial, resource, and safety barriers were contraception knowledge gaps, lack of financial reimbursement, lack of physicians to create a collaborative practice agreement, and increased liability, respectively. Pharmacies wanting to implement this service (n = 85) were early change adopters (P <.001), wanted to implement more direct patient care (P <.001), could create collaborative practice agreements (P <.001), had needed resources (P <.001), and were motivated by competition (P <.001) than pharmacies not wanting to implement this service (n = 61). They also felt their patients would value (P <.001) and use (P <.001) pharmacist‐prescribed contraception. Geographical location, city size, pharmacy type, and prescription volume did not significantly differ between pharmacies wanting to implement or not this service. Conclusion: Pharmacies wanting to implement pharmacist‐prescribed contraception service had more positive attitudes, and better knowledge, skills, and resources than those not wanting to implement the service. Many implementation barriers existed requiring solutions and advocacy efforts by community pharmacy staff, organizations, and colleges to increase implementation of this service in community pharmacies. [ABSTRACT FROM AUTHOR] |
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