Across most of Australia, the role of community pharmacists in contraceptive care has been unchanged since 2004. To understand their current scope of practice and potential for practice advancements, Buckingham et al (2022) examined community pharmacists' contraceptive knowledge and their attitudes, practices and perceived barriers to and benefits of contraceptive counselling provision. Eligible responses were received from 366 pharmacies. Pharmacists' median age was 34. Most (85%) pharmacists agreed that contraceptive counselling fits within their current professional activities and emphasised benefits to their patients, including improved access to contraceptive decision support (80%), as being key motivators of counselling.
A lack of payment mechanisms (66%), training opportunities (55%) and technical assistance tools (54%) were the most important barriers. Self-rated knowledge and confidence were highest for combined oral contraceptive pills and lowest for the copper intrauterine device (IUD). When tested, pharmacists were very knowledgeable about method, dosage, frequencies and costs, and relatively less knowledgeable about side-effects and IUD suitability for adolescents. “These community pharmacy task-sharing initiatives include pregnancy options counselling, interventions integrating contraceptive care across community and clinic-based services, and legislative amendments providing pharmacists with practice licensing authority to dispense hormonal contraception without a physician's prescription,” the authors wrote.
Outcomes from the survey included practices, reported and tested knowledge, attitudes, confidence, benefits, and barriers. They added that Australian pharmacists have limited opportunities after undergraduate degrees for contraceptive knowledge, which is similar to findings in the US, where ‘most pharmacists described contraceptive education in the pharmacy curricula as being inadequate to prepare them for contraception prescribing’.
In areas where GPs were scarce, pharmacies were most likely to have a private consultation room and advanced accreditation, according to study authors. They said this provides an opportunity for pharmacists to increase access to contraception methods and counselling in communities that lack these services, and that most pharmacists felt positive about these services. To decrease barriers reported by pharmacists, researchers recommended policy level changes such as medicine rebates and federal pharmacy funding agreements. In addition, they said pharmacy curricula changes and professional development opportunities would also decrease these barriers. Researchers said that Australian community pharmacists know contraceptive counselling is good for both public health and for patients. They said pharmacists reported being enthusiastic about expanding their scope of practice for contraceptive care. “Community pharmacists provide contraceptive information and counselling but lack the necessary resources and support to be able to consistently provide quality, person-centred care,” the researchers concluded. They said that payment mechanisms, pharmacy-specific professional resources, and training opportunities need additional exploration to provide support for pharmacists to offer high quality, patient-centred contraceptive care.
CONCLUSIONS
Community pharmacists provide contraceptive information and counselling but lack the necessary resources and support to be able to consistently provide quality, person-centred care. Remuneration mechanisms, training opportunities and pharmacy-specific professional resources need to be explored.
References available on request.
