Washington pharmacist prescriber project a hit

Increased access to emergency contraceptive pills (ECPs) is making an impact on the lives of women in Washington state, thanks to a unique provider/pharmacist collaborative project.

In the first month following the Washington State Pharmacist Prescriber Project's February media launch, about 500 ECP prescriptions were written, says Jane Hutchings, MPH, senior program officer at Program for Appro priate Tech nology in Health (PATH).

The project is a collaboration among PATH, the Washington State Pharmacists Association, the Uni versity of Washington Department of Phar macy, the Washington State Board of Pharmacy, and Elgin DDB Needham advertising agency, all in Seattle. (See Contraceptive Technology Update, March 1998, pp. 34 and 39, for more details. The project uses provider/pharmacist collaborative agreements to give pharmacists prescriptive authority to write and fill ECP prescriptions.)

One pharmacy chain reported filling 141 ECP prescriptions between Feb. 22 and March 16, compared with seven prescriptions for the previous two months, Hutchings says. Individual pharmacies, especially those that are open 24 hours or until midnight, are reporting filling as many as 11 prescriptions on a weekend day, she notes. The majority of women using the pharmacy ECP service are above 18 years old, according to initial survey results.

Calls to the national Emergency Contraception Hotline (1-888-NOT-2-LATE) have jumped since news of the project began circulating in the media, she says. More than 1,287 calls were logged from the project area in March, which represents a significant increase over January's 116 calls from the same area.

While the response from the public has been overwhelmingly positive since the February media launch, anti-abortion groups have sent letters, she reports. One project collaborator and some of the drugstore chain corporate headquarters have received a few letters complaining about their participation in the project. Responses to these letters have been clear in distinguishing ECP's mechanism of action as pregnancy prevention and not abortion. There has been no organized public picketing or protesting of participating pharmacies, though, Hutchings says.

Many pharmacies have heard supportive comments from customers, she says. This support is evident in the response cards mailed in by ECP users following their pharmacy experience.

About 10% of the women receiving ECPs through prescriptive authority have completed and mailed the anonymous written surveys. Although these responses represent only the first month of experience with pharmacists prescribing ECPs, they are extremely positive, Hutchings says.

"Women ranked interaction with the pharmacist very high on such issues as degree of respect shown by the pharmacist to the client, presentation of information in a way that was comprehensible, and whether there was ample time for the client to ask questions," she says. "The overwhelming majority of women said they would tell other women about this option."

Convenience is important when it comes to pharmacy access to ECPs, initial survey responses show. Some women chose the pharmacy because they didn't want their regular provider to know about their ECP use, while others had no regular physician or clinic. Half of the women responding said they would have waited to see if they became pregnant if they could not have received ECPs through a pharmacy.

Pharmacists back project

More pharmacists are joining the project, with more than 80 pharmacies now on file with the Washington State Board of Pharmacy. The number of collaborative agreements submitted to the Board is growing daily, Hutchings says, and those involved have linked to the national EC Hotline.

More than 400 pharmacists have been trained in multiple sessions scheduled at various locations in the project area. Considerable interest has come from outside the designated project area in western Washington. To address that interest, the state pharmacists' association presented (with its own resources) a well-attended training in Spokane.