PHARMACIST-PRESCRIBED MEDICATION ABORTION: A QUALITATIVE EXPLORATION IN MASSACHUSETTS

Objectives

Efforts to increase access to medication abortion in the US are urgently needed. We gathered the perspectives of key partners in Massachusetts to explore expanding medication abortion access through a pharmacist-prescribed care model.

Methods

Between January and October 2024, we conducted 31 interviews with patients, pharmacists, policymakers, clinicians, and advocates in Massachusetts. Interviews explored views on pharmacy-based medication abortion access, key patient support needed, and the barriers and facilitators to implementation. Interviews were analyzed thematically using MAXQDA.

Results

Participants were largely supportive of the model, indicating that pharmacist-prescribed medication abortion could improve access, particularly for communities who face barriers, including young people, unhoused individuals, and those in rural settings or with limited transport. Other benefits included faster access to care compared to in-clinic or telemedicine models. However, a variety of challenges were raised, including a lack of confidential counseling spaces, concerns around reimbursement for pharmacists’ services, and limited staff time and resources. Key factors for successful implementation were thought to include comprehensive follow-up care, enhanced privacy in pharmacies, affordable pharmacist training, insurance coverage of patient care and pharmacist counseling, and coalitions comprising community organizations and abortion providers.

Conclusions

Our findings contribute to the growing body of literature showing the potential benefits of expanding pharmacists’ role in abortion care in the US and highlights the importance of addressing structural and financial challenges for successful implementation and expansion of abortion care.