Direct Pharmacist Prescribing of Emergency Contraception: Findings of an Academic Detailing Intervention Pilot Study

Abstract

Purpose This exploratory study tested the effectiveness of an academic detailing (AD) intervention for improving pharmacist emergency contraception (EC) practices compared to a handout intervention in a state where pharmacists can prescribe EC using a statewide protocol. AD is a peer educational outreach designed to encourage evidence-based practices that improve patient outcomes and healthcare costs. Methods In this pilot randomized controlled trial, four community pharmacies in San Diego County, California, received an AD intervention or a control handout intervention regarding pharmacist prescribing of EC. The AD intervention group received a one-hour training from an expert pharmacist regarding EC prescribing and an informational EC handout, while the handout intervention group received only the handout. Participants completed a survey assessing EC practices, knowledge, and attitudes before and after the interventions. Phone interviews were performed one month following the interventions. Participants in the AD intervention group demonstrated greater knowledge of clinical considerations for prescribing ulipristal acetate (UPA) EC and California statewide protocols for pharmacist prescribing of EC compared to the handout intervention. Participants in the AD intervention were also more likely to have begun prescribing EC following the intervention compared to those in the handout intervention, which was observed in both quantitative and qualitative results. Increased prescribing rates in the AD intervention group highlight the utility of AD for implementation of pharmacist services. Training that focuses on the clinical considerations for the EC products and statewide protocol for pharmacists’ prescribing of EC could lead to increased community access to EC in pharmacies and more accurate counseling by pharmacists.