For a study, researchers sought to determine if pharmacist prescriptions for combination hormonal contraception were related to 12-month contraceptive continuation rates or gaps in contraceptive coverage. From January 1, 2016, to December 31, 2018, they conducted a retrospective cohort analysis of all short-acting, hormonal contraception users (pill, patch, ring, injectable) in Oregon’s All-Payer All Claims database. Using diagnostic and National Drug Classification codes, they recorded contraceptive usage. They utilized logistic regression to examine the relationship between a pharmacist’s prescription and 12-month contraceptive continuation rates and gaps in contraceptive coverage. Age, rurality, and payer were model variables.
The survey included 172,325 contraceptive users, with 1,512 (0.9%) getting their prescriptions from a pharmacy. Pharmacists were substantially more likely than doctors to prescribe to women aged 25 to 34 years (50.5% vs 36.9%, P<.05), in urban areas (88.4% vs 81.7%, P<.05), and with commercial insurance (89.2% vs 59.5%, P<.05). They discovered that the rate of 12-month contraceptive continuation was greater among those who had a pharmacist prescription (34.3% vs 21.0%, P<.01). In an adjusted model, persons with any pharmacist prescription had a 61.0% greater chance of continuing contraception at 12 months (adjusted odds ratio [aOR] 1.61, 95% CI 1.44–1.79) than those with clinician prescriptions. Over a 6-month period, the majority of contraceptive users in both groups (61.6% vs 61.9%, P=.89) encountered a break in coverage, defined as a gap of 1–29 days between prescriptions. Contraceptive discontinuation was not linked with prescriber type (aOR 1.03, 95% CI 0.90–1.18).
When compared to doctor prescriptions, pharmacist prescriptions for contraception were related to a higher likelihood of 12-month contraceptive retention rates. However, the incidence of interruptions in contraceptive coverage was comparable for pharmacists and clinic-based prescribers.