Author ORCID Identifier

https://orcid.org/0000-0001-7612-1587

Date Available

5-28-2022

Year of Publication

2021

Document Type

Master's Thesis

Degree Name

Master of Science (MS)

College

Pharmacy

Department/School/Program

Pharmaceutical Sciences

Advisor

Dr. Patricia R. Freeman

Abstract

Unintended pregnancy continues to be a prevalent issue across the United States, impacting millions of women annually. While several states have enacted policies expanding pharmacist services to allow for provision of hormonal contraception, Kentucky has yet to do so. Likewise, although provision of nonprescription hormonal contraception could be authorized under Kentucky regulation, prior to this study, this had yet to be done. The objectives of this study were to 1) understand the opinions of Kentucky pharmacists and student pharmacists regarding provision of hormonal contraception services through a board-authorized protocol, 2) understand the opinions of Kentucky pharmacists and student pharmacists regarding provision of nonprescription emergency contraception services through a board-authorized protocol, and 3) identify and implement policy-based solutions to increase access to nonprescription emergency contraception.

Two questionnaires, both approved by the University of Kentucky Institutional Review Board (IRB) were developed via REDCap with questions pertaining to pharmacists and student pharmacists, respectively. The pharmacist questionnaire was disseminated via email or private Facebook group post to a convenience sample of Kentucky pharmacists. The student pharmacist questionnaire was disseminated via Canvas to first through third professional year (PY1-PY3) students at the University of Kentucky College of Pharmacy. Surveys were analyzed using descriptive statistics. A multivariable logistic regression model was used for both surveys to identify any significant differences in odds of support for provision of hormonal contraception across various demographic factors. Additionally, McNemar’s test was used for both surveys to identify any significant differences in support between dosage forms. A protocol for provision of emergency contraception was created and presented for approval to the Kentucky Board of Pharmacy. Development of a training program was initiated and plans for future implementation strategies were begun.

Pharmacists were found to be generally supportive of provision of hormonal contraception, with support being highest for oral (61%) and transdermal (54%) dosage forms. While lower, support was existent for provision of injectable (38%) and vaginal (47%) dosage forms as well. Students, however, were largely supportive of oral (91%), transdermal (82%), vaginal (73%), and injectable (66%) dosage forms. Support regarding provision of emergency contraception via board-authorized protocol was high for both pharmacists (65%) and student pharmacists (88%). Multivariable logistic regression analyses showed that pharmacists in practice 11-30 years were found to be at significantly decreased odds of support for oral, transdermal, and vaginal dosage forms compared to those in practice 10 years or less. With regard to the student survey, PY3 students were found to be at higher odds of support for provision of the oral and vaginal dosage forms. Additionally, students who anticipate practicing in a hospital inpatient setting were at higher odds of support for provision of the injectable dosage form. A protocol for provision of nonprescription emergency contraception was approved by the Kentucky Board of Pharmacy and training program development remains underway.

This work provides the framework for pharmacists to provide nonprescription emergency contraception via protocol. Additionally, data collected regarding pharmacist and student pharmacist opinions provide the foundation for discussion regarding pharmacist provision of hormonal contraception in Kentucky.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2021.185

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