Role of Pharmacists in Hormonal Contraceptive Access: A Survey of North Carolina Pharmacists.

The role of pharmacy in healthcare continues to evolve as pharmacists gain increased clinical responsibilities in the United States, such as the opportunity to prescribe hormonal contraception. Currently, North Carolina (NC) pharmacists do not have this ability. While previous research focused on the perceptions of community pharmacists surrounding this practice, no previous research surveyed all pharmacists in a state. This cross-sectional, web-based survey was distributed to all actively licensed pharmacists residing in the state of NC in November 2018. The primary objective was to determine the likelihood of NC community pharmacists to prescribe hormonal contraception. Secondary outcomes included: evaluation of all respondent support and perceptions of this practice as advocacy occurs on the state organization level and unified support is critical; opinions regarding over-the-counter (OTC) status of contraception; and potential barriers to prescribing. Overall, 83% of community pharmacists were likely to prescribe hormonal contraception. No differences in likelihood to prescribe were detected between geographic settings. Community pharmacists reported that the most common barriers to impact prescribing were added responsibility and liability (69.8%) and time constraints (67.2%). Fewer than 10% of respondents felt that hormonal contraception should be classified as OTC (7.9%). Noncommunity pharmacists were significantly more likely to agree that prescribing hormonal contraception allows pharmacists to practice at a higher level, that increased access to hormonal contraception is an important public health issue, and that rural areas would benefit from pharmacist-prescribed hormonal contraception. Overall, this study found a willingness to prescribe and support from the majority of both community and noncommunity pharmacists. Limitations of the study included a low response rate and potential nonresponse bias. Future research is needed to address solutions to potential barriers and uptake of this practice, if implemented.

Examining community-based pharmacist perceptions on the care of transgender patients.

OBJECTIVE: The objective of this study was to determine whether community-based pharmacists in North Carolina have the personal confidence, comfort level, and resources needed to care appropriately for and interact with transgender patients. METHODS: Using the North Carolina Board of Pharmacy database, a link to a 25-item questionnaire was e-mailed to all actively licensed community pharmacists in North Carolina. Survey items included pharmacist demographics, prior or current education on transgender health care, comfort regarding care provision for transgender patients, and the ability to care for transgender patients at the practice site. Questionnaire items were developed in collaboration with a pharmacist who actively participates in the care of transgender patients. The questionnaire was pilot-tested among a convenience sample of student pharmacists and pharmacists for feedback on validity and question structure. The survey was open for 30 days with a reminder sent on day 15. Upon survey completion, participants had the option to be entered into a drawing to receive a gift card incentive. RESULTS: In total, 342 surveys were completed of 4784 surveys distributed, yielding a 7.1% response rate. Three percent of survey respondents reported receiving education on treating transgender patients during their respective pharmacy school curricula, and 12% of respondents sought other forms of transgender education (i.e., continuing education). Seventy-one percent of respondents viewed the role of the pharmacist as important in the care of transgender patients. Sixty-six percent of respondents were comfortable welcoming transgender patients into their practice sites, and 36% were comfortable asking for pronouns. CONCLUSION: Survey participants reported a lack of formal or postgraduate education, which describes a need for accessible education on transgender care. North Carolina community-based pharmacists believe that it is within their role as pharmacists to provide gender-affirming care, but they may need additional training to feel comfortable in providing this care.

Breastfeeding Support in a Community Pharmacy: Improving Access through the Well Babies at Walgreens Program.

Well Babies at Walgreens is a unique community-based corporate partnership program that offers breastfeeding support by a lactation professional in a private room at the pharmacy. Walgreens is a community pharmacy chain with more than 8000 locations in the United States, Puerto Rico, and the US Virgin Islands. The primary goal of Well Babies is to support breastfeeding women using a model that is expandable to other Walgreens pharmacy sites. The Well Babies program offers drop-in services, with a professional consultation by a lactation consultant and baby weight check, if desired. Well Babies creators are developing a business plan for Walgreens and a toolkit that would help other stores implement the program. An additional goal is to improve continuity of care for breastfeeding by engaging pharmacists as vital members of the health care team. Offering breastfeeding support at a pharmacy improves access and encourages support persons to attend while simultaneously allowing the family to complete other errands. This initiative included education for pharmacists to improve the recommendations they make for breastfeeding mothers and to improve awareness among pharmacists of the benefits associated with breastfeeding and the need to preserve the breastfeeding relationship. The first drop-in location opened in April 2012. Grant funding from the US Centers for Disease Control and Prevention, awarded to the Indiana State Department of Health, made it possible to open a second drop-in location in June 2013. Future plans include developing an employee lactation program and expanding Well Babies at Walgreens at other store locations.