August 15, 2006
UW study to test whether women will bridge gap in birth control coverage by going directly to pharmacists
A University of Washington-led study will examine whether women whose birth control prescriptions have expired would be interested in receiving contraceptives directly from a community pharmacist.
The study is a continuation of the UW Department of Pharmacy’s Direct Access Study, which found that it was feasible for pharmacists to directly prescribe contraceptives to women who had answered a targeted medical history questionnaire and undergone a blood pressure check. The pharmacists in both studies have entered collaborative drug therapy agreements with a physician, and have received appropriate training on prescribing birth control.
The new research project, known as the Bridging Study, is aimed at women who have already been using birth control but whose prescriptions have expired, or women who have used prescribed birth control in the past two years.
“We take women who have been out of the medical system for a while, and we give them an easy entry back into the system,” explained Don Downing, UW clinical associate professor of pharmacy and a co-investigator in the study.
The earlier Direct Access Study found that about 85 percent of women coming to pharmacists for birth control prescriptions were already using the contraceptives, or had in the past. Some of the women had relocated to Seattle and not yet visited a doctor for a new birth control prescription, or had recently started a new relationship and needed to re-start their use of birth control. Researchers would like to more closely examine whether women with recent birth control prescriptions would rely on pharmacist-prescribed contraceptives to bridge the gap until a future doctor’s visit.
The new study is taking place at three Fred Meyer grocery store pharmacies — at the Covington store in Kent, the South Hill location in Puyallup, and the Totem Lake store in Kirkland — and at three Bartell Drug stores — the Queen Anne and University Village locations in Seattle, and the Redondo store in Des Moines.
Researchers are recruiting participants now for the new study. Participants must be women who are 18 to 45 years old and have used oral contraceptives before, but did not participate in the first phase of the Direct Access Study. Women participating in the study will have to pay $25 for the initial medical questionnaire and blood pressure screening, as well as the cost of the birth control pills. This study provides three months of the contraceptives, and at the end of the study women receive a referral to a health-care provider for ongoing birth control and wellness check-ups.
Pharmacists in Washington state have long had the ability to directly prescribe certain drug treatments — annual flu shots are often given by pharmacists, and emergency contraception has been available from pharmacists in Washington since 1998. These and others are examples of pharmacists working with physicians under collaborative drug therapy agreements, in which doctors help train pharmacists how to directly provide drug prescriptions.
The Direct Access Study relies on the same concept to help boost the accessibility and availability of contraception for women. Typically, women have had to get a pelvic and breast exam and a pap smear from their doctor in order to receive birth control, even though the preventive care is unrelated to family planning and contraception. The researchers have found that women still see their doctors for preventive care, even if they receive birth control directly from a pharmacist.
“The first phase of the Direct Access Study was a feasibility test to see if this program could work, and it worked well,” said Dr. Jacqueline Gardner, professor of pharmacy at the UW and principal investigator of the study. “We knew that pharmacists could do this — they have the qualifications and capabilities. We wanted to see if women would take advantage of this increased access, and they have.”
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NOTE: For more information about the Direct Access Study, or to sign up as a study participant, visit the study’s Web site at http://www.directaccessstudy.info/
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