Abstract
Pharmacist contraceptive prescribing increases contraceptive access and is becoming more broadly implemented across the United States. University settings are important targets for expanding contraceptive access, as unintended pregnancy is a common reason for young women to drop out of school. Our objective was to describe young people's perceptions of barriers and facilitators to university campus pharmacist prescribing.
The patient-pharmacist consult includes a blood pressure check, contraindication screen, and contraceptive counseling. The pharmacist can prescribe up to a year's supply of the pill, patch, ring, injection, gel, and/or diaphragm. Referrals are made if long-acting reversible contraception is desired. A subset of all patients between September 2022 and May 2023 completed an individual, recorded 30-minute interview on their perception of and experience with the pharmacy service, barriers to contraceptive access, and decision making around contraceptive choice. Example questions included “What was your experience accessing hormonal contraception?”. Interviews were transcribed and uploaded into NVivo for inductive thematic analysis. Example codes included “Lack of contraception providers”. Two authors (CC/KD) coded the interviews and differences were resolved by discussion. The study was determined by the IRB to be exempt.
Participants were 16 Purdue students: median age 20.5 years (range 18-39 years) and self-identified ethnicity of 69% white and 38% Asian (one participant identified as white and Asian). Barriers to contraceptive access included long wait times for physicians, transportation cost and distance, privacy concerns, and primary care doctors referring out for contraceptive care. The patients were able to identify pharmacy and service characteristics they found beneficial including the convenience of having the pharmacy on campus, ability to immediately pick up their medicine after the appointment, and pharmacist knowledge and demeanor. The identified drawbacks of the service involved the out-of-pocket cost for the consult (generally perceived as high). The service was highly rated by all interview participants with an average score of 9.3 out of 10 for recommending it to a friend.
Overall, a campus pharmacist contraceptive prescribing service was accessible and acceptable to students. It addresses many of the barriers to receiving contraceptives from medical providers in clinic settings and provides a model for providing contraceptives in high need settings, such as universities and contraceptive deserts. Data suggest a need for advocacy around out-of-pocket costs.