探索印度德里药物流产药片的可用性和可及性：社区药房神秘顾客研究。

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2024-11-08 DOI:10.1016/j.contraception.2024.110745

Anvita Dixit , Dipesh Suvarna , Raywat Deonandan , Angel M. Foster

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引用次数: 0

摘要

目的：尽管在印度，药物流产药物在技术上需要处方，但研究表明，这些药物通常可以直接从药店买到。我们在首都德里开展了一项神秘客户研究，以探讨米非司酮/米索前列醇在没有处方的情况下的可用性、可及性和药房配药方法：研究设计：我们使用两个预先确定的客户档案--一个是未婚女性，另一个是其男性伴侣--走访了不同社区的社区药店。神秘顾客在妊娠试验呈阳性后，以要求 "让月经恢复 "的 "一片药 "开始互动。我们记录了产品的可用性、价格和结果，并评估了客户与药店工作人员互动的质量。我们使用描述性统计和主题对这些接触进行了分析：2022 年底，我们对 86 家药店进行了 172 次访问。半数以上的药店（n=91，53%）提供药物流产药，我们的神秘客户在22%（n=37）的访问中无需处方即可购买药物。女性和男性客户购买米非司酮/米索前列醇的次数相似，但我们认为药剂师与男性客户的互动更为积极。药剂师提供了不同的方案信息，而且接触时间很短：在印度德里，有相当一部分药店似乎无需处方即可提供药物流产药物。我们的研究结果表明，有必要确定与药房工作人员合作的方式，以支持他们提供有关米非司酮/米索前列醇最佳方案的准确医学信息：在印度，通过药房获取米非司酮/米索前列醇有可能大大减少获得人工流产护理的障碍。尽管从技术上讲需要处方，但在德里的部分药店可以买到非处方药流产药物。未来有必要对药房渠道的正规化和支持进行研究，并探索寻求堕胎者在药房渠道方面的经验。

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Exploring the availability and accessibility of medication abortion pills in Delhi, India: A mystery client study in community pharmacies

Objectives

Although medication abortion drugs technically require a prescription in India, research suggests that they are often available directly from pharmacies. We conducted a mystery client study in the capital city of Delhi to explore the availability, accessibility, and pharmacy dispensing practices of mifepristone/misoprostol in the absence of a prescription.

Study design

Using two predetermined client profiles—one of an unmarried woman and one of her male partner—we visited community pharmacies in different neighborhoods. Mystery clients began the interaction with a request for “a pill to bring back” a period after a positive pregnancy test. We documented product availability, price, and outcome and assessed the quality of the client–pharmacy worker interaction. We analyzed these encounters using descriptive statistics and for themes.

Results

In late 2022, we made 172 visits to 86 pharmacies. Medication abortion pills were available at more than half of the pharmacy visits (n = 91, 53%), and our mystery clients purchased the drugs without a prescription during 22% (n = 37) of all visits. The woman and man clients purchased mifepristone/misoprostol on a similar number of occasions, but we assessed the pharmacy worker interactions with the man as more positive. Pharmacy workers provided varied information about the regimen, and the encounters were brief.

Conclusions

Medication abortion drugs appear to be available without a prescription in a sizable minority of pharmacies in Delhi, India. Our findings suggest that identifying ways to work with pharmacy workers to support their ability to provide medically accurate information about the optimal mifepristone/misoprostol regimen is warranted.

Implications

Pharmacy access to mifepristone/misoprostol has the potential to greatly reduce barriers to accessing abortion care in India. Despite technically requiring a prescription, medication abortion drugs are available behind the counter at a sub-set of pharmacies in Delhi. Future research on formalizing and supporting pharmacy access and exploring abortion seekers’ experiences with pharmacy access is warranted.

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.