Pharmacist direct dispensing of mifepristone for medication abortion in Canada: a survey of community pharmacists
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 in...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/10/e063370.full |
| _version_ | 1811250099783729152 |
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| author | Wendy V Norman Sarah Munro Judith A Soon Enav Z Zusman |
| author_facet | Wendy V Norman Sarah Munro Judith A Soon Enav Z Zusman |
| author_sort | Wendy V Norman |
| collection | DOAJ |
| description | 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, χ2 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. |
| first_indexed | 2024-04-12T15:59:04Z |
| format | Article |
| id | doaj.art-26785bee39384641babe96f78e6653ef |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-12T15:59:04Z |
| publishDate | 2022-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-26785bee39384641babe96f78e6653ef2022-12-22T03:26:16ZengBMJ Publishing GroupBMJ Open2044-60552022-10-01121010.1136/bmjopen-2022-063370Pharmacist direct dispensing of mifepristone for medication abortion in Canada: a survey of community pharmacistsWendy V Norman0Sarah Munro1Judith A Soon2Enav Z Zusman3Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada3 Department of Obstetrics & Gynecology, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada6 Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada1 Collaboration for Outcomes Research and Evaluation, The University of British Columbia Faculty of Pharmaceutical Sciences, Vancouver, British Columbia, CanadaIntroduction 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, χ2 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.https://bmjopen.bmj.com/content/12/10/e063370.full |
| spellingShingle | Wendy V Norman Sarah Munro Judith A Soon Enav Z Zusman Pharmacist direct dispensing of mifepristone for medication abortion in Canada: a survey of community pharmacists BMJ Open |
| title | Pharmacist direct dispensing of mifepristone for medication abortion in Canada: a survey of community pharmacists |
| title_full | Pharmacist direct dispensing of mifepristone for medication abortion in Canada: a survey of community pharmacists |
| title_fullStr | Pharmacist direct dispensing of mifepristone for medication abortion in Canada: a survey of community pharmacists |
| title_full_unstemmed | Pharmacist direct dispensing of mifepristone for medication abortion in Canada: a survey of community pharmacists |
| title_short | Pharmacist direct dispensing of mifepristone for medication abortion in Canada: a survey of community pharmacists |
| title_sort | pharmacist direct dispensing of mifepristone for medication abortion in canada a survey of community pharmacists |
| url | https://bmjopen.bmj.com/content/12/10/e063370.full |
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