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Medical contraindications to combined hormonal contraceptive use among women using methods prescribed by a pharmacist.
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- Author(s): Rodriguez, Maria I.1,2 (AUTHOR) ; Kaufman, Menolly2 (AUTHOR); Manibusan, Brynna2 (AUTHOR); Anderson, Lorinda3 (AUTHOR); McConnell, K. John2 (AUTHOR)
- Source:
Contraception. Nov2021, Vol. 104 Issue 5, p547-552. 6p.- Subject Terms:
- Source:
- Additional Information
- Subject Terms:
- Abstract:
Objective: To determine whether pharmacist prescription of combined hormonal contraception is associated with inappropriate prescription to women with medical contraindications.Study Design: We conducted a retrosopective cohort study of all short-acting, hormonal contraceptive users (pill, patch, ring, injectable) in Oregon's All Payer All Claims database from January 1, 2016 to December 31, 2018. Our primary outcome was the proportion of women receiving a combined hormonal method who had a Medical Eligibility Category (MEC) 3 or 4 condition. We identified potential contraindications using International Classification of Disease codes. We conducted descriptive analyses of contraindication prevalence and prescription error rate by prescriber type. We used a multivariable logistic regression model to test the association between pharmacist prescriber and population characteristics.Results: Our study sample consisted of 439,240 contraceptive users, of which 3782 (0.86%) received their prescriptions from a pharmacist. Women aged 25 to 29 were more likely than women over age 35 to receive contraception from a pharmacist (adjusted odds ratio (aOR) 2.74, 95% confidence interval [CI] 2.44-3.08). Pharmacist prescriptions were slightly less likely in rural areas (aOR 0.78, 95% CI 0.69-0.89) and among women on Medicaid, relative to those with commercial insurance (aOR 0.21, 95% CI 0.19-0.24). Among women given contraception in a clinical setting, 4.25% had evidence of an MEC 3 or 4 contraindication, compared to 0.9% for women seen by a pharmacist. Rates of prescribing a combined method to women with a potential contraindication were not meaningfully different by prescriber type (2.16% for clinicians vs 0.74% for pharmacists).Conclusion: Rates of contraceptive prescribing with a contraindication were relatively low and did not differ between clinicians and pharmacists.Implications: Pharmacists can safely screen for medical contraindications to combined hormonal contraception. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of Contraception is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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