Pharmacy access to emergency contraception in California.

CONTEXT: California is one of eight states that allow a woman to obtain emergency contraceptives from a pharmacy without a physician prescription. Because many women do not know about emergency contraception or direct pharmacy access, it is important to understand barriers to getting the method and women's reasons for choosing the pharmacy option. METHODS: In a 2004 survey at 25 predominantly independent pharmacies across California that offered pharmacy access, 426 women completed questionnaires after obtaining emergency contraceptives. They were asked about their reasons for seeking the method, the time of unprotected intercourse, barriers to access, how they learned about pharmacy access and their reasons for choosing it. Chi-square tests and analysis of variance were used to assess differences between subgroups. RESULTS: Eighty-six percent of women wanted emergency contraceptives for immediate use, and women obtained the method an average of 36 hours after unprotected intercourse. Those younger than 16, those who had had unprotected sex on the weekend and those who were embarrassed to ask for the method or who did not know about it all took a longer time to get the medication than did their respective comparison groups. Women who chose pharmacy access did so because they thought it was faster (54%) and more convenient (47%) than seeking a physician prescription. The majority reported that talking to a pharmacist was very helpful (84%) and that it was very important to be able to get the method directly from a pharmacy (81%). CONCLUSIONS: Increasing women's knowledge about emergency contraception and its availability directly from pharmacies has the potential to improve the effectiveness of this contraceptive method by reducing the time interval between unprotected intercourse and initiation of treatment.

Future of emergency contraception lies in pharmacists' hands.

OBJECTIVE: To increase community pharmacists' awareness about issues related to the provision of emergency contraception (EC) to women by describing pharmacist outreach and training programs and discussing pharmacy access and stocking issues, California's EC Pharmacy Program, methods for raising pharmacists' awareness, and professional development opportunities. SUMMARY: EC is both safe and effective in reducing the risk of unintended pregnancy after unprotected intercourse, yet awareness of and demand for the medication has not been high, and it often is not stocked in pharmacies. Various advocacy organizations have engaged in educating the public and physicians about EC, but relatively little attention and few resources have been targeted to ensure that the pharmacy community is aware of and educated about EC. Increased visibility and access to EC in the several states that allow pharmacists to provide EC directly to women have resulted from the active participation and leadership of pharmacists. In these states, women are showing interest in and receptivity to reproductive health services provided by pharmacists. In California, some 3000 pharmacists statewide have completed training, and in 2004 they provided EC directly to approximately 175,000 women. Pharmacists who provide EC overwhelmingly (91%) report that they do so because they see it as an important community service, and many (57%) recognize the opportunity for professional development. CONCLUSION: Pharmacists are uniquely positioned to improve access to EC, and leadership within the pharmacy community can facilitate efforts to improve access. Increased education and training of pharmacists about EC--such as continuing education programs available online at www.pharmacyaccess. learnsomething.com--are critical to ensure not only that EC is available in pharmacies but also that pharmacists are engaged in meeting the reproductive health needs of women. Increased access to EC can expand pharmacists' role in health care provision. State-specific information about EC pharmacy access initiatives is available on the Web at www.GO2EC.org.