Changes in local access to mifepristone dispensed by community pharmacies for medication abortion in Ontario: a population-based repeated cross-sectional study.
Laura Schummers, Michael R Law, Kimberlyn McGrail, Elizabeth K Darling, Enav Z Zusman, Sheila Dunn, Janusz Kaczorowski, Anastasia Gayowsky, Peter Gozdyra, Wendy V Norman
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引用次数: 0
Abstract
Background: Although mifepristone for medication abortion has been available in Canada since a regulatory change in 2017, leading to its rapid uptake, the effects of this availability on regional access to abortion are unknown. We sought to examine how community pharmacy dispensation of mifepristone affected distribution of abortion services over time in Ontario, Canada.
Methods: We used linked health administrative data to identify a cohort of all medication and procedural abortions provided in Ontario from 2017 to 2022, defined by outpatient mifepristone dispensations and abortion billing, diagnostic, and procedure codes. We evaluated changes over time in the annual proportion of community pharmacies that dispensed mifepristone and the availability and distribution of medication and procedural abortion services across geographic regions, defined by postal code forward sortation areas.
Results: In 2017, 2% of Ontario pharmacies filled 1 or more prescriptions for mifepristone, which increased to 20% in 2022. In 2017, few regions contained a mifepristone-dispensing pharmacy (19%) or procedural abortion service (18%). By 2022, most regions had local access to a mifepristone-dispensing pharmacy (77%), with geographically distributed abortion services across Ontario. Although only 37% of abortion service users lived in a region with either a mifepristone-dispensing pharmacy or procedural provider in 2017, this increased to 91% by 2022.
Interpretation: Access to medication abortion across Ontario increased substantially within 5 years of mifepristone's availability as a normally prescribed and dispensed medication. This regulatory approach appears successful for achieving widespread access to local abortion services.
期刊介绍：
CMAJ (Canadian Medical Association Journal) is a peer-reviewed general medical journal renowned for publishing original research, commentaries, analyses, reviews, clinical practice updates, and editorials. Led by Editor-in-Chief Dr. Kirsten Patrick, it has a significant impact on healthcare in Canada and globally, with a 2022 impact factor of 17.4.
Its mission is to promote knowledge vital for the health of Canadians and the global community, guided by values of service, evidence, and integrity. The journal's vision emphasizes the importance of the best evidence, practice, and health outcomes.
CMAJ covers a broad range of topics, focusing on contributing to the evidence base, influencing clinical practice, and raising awareness of pressing health issues among policymakers and the public. Since 2020, with the appointment of a Lead of Patient Involvement, CMAJ is committed to integrating patients into its governance and operations, encouraging their content submissions.
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