(1355) Qualitative Assessment of Recommendations from an Interprofessional Hormonal Contraception Summit to Increase Uptake and Impact of Pharmacist-prescribed Contraception

Objectives: The objective of this study was to perform a qualitative analysis of recommendations gleaned from an interprofessional contraception summit focused on enhancing uptake and impact of pharmacist-prescribed hormonal contraception.

Methods: An interprofessional contraception summit was held in August, 2023, as part of a $705,000 grant from The Duke Endowment to support implementation and evaluation of pharmacist-prescribed hormonal contraception. A curated list of invitees was developed by the grant team that included a diverse group of stakeholders including community pharmacists, state pharmacy association leaders, Board of Pharmacy leaders, faculty from all schools and colleges and pharmacy in the state, community-based pharmacy residency programs, physicians from family medicine, pediatrics, and obstetrics and gynecology, the state medical director, the American Civil Liberties Union, Planned Parenthood, Sister Song, Upstream USA, commercial payers, Medicaid, and legislators. Student pharmacists and pharmacy residents who were engaged in other aspects of The Duke Endowment grant were also invited. Didactic sessions and facilitated discussions focused on the history of contraception legislation, elements of the statewide protocol, and early adopter experiences. Attendees were divided into small groups for facilitated round table discussions to elicit recommendations about how to increase pharmacist training uptake and achieve the goal of having a birth control pharmacist in all 100 counties of the state. The state health director (Betsey Tilson, MD) and a national contraception expert (Paige Clark, RPh) served as keynote speakers. Attendees were asked to provide a recommendation for "The One Thing" that should be done within the next year to increase the uptake and impact of pharmacist-prescribed hormonal contraception. Recommendations were written on individual index cards and collected at the end of the summit. These qualitative data were collated and analyzed using inductive coding by members of the research team. The coded data were categorized into broader themes to determine priority areas of focus in year 2 of the grant.

Results: Eighty participants attended the half-day event. Fifty-six participants (70%) submitted a "The One Thing" recommendation at the end of the contraception summit and six themes were identified including advocacy for minors, community partnerships, birth control pharmacist workforce, patient outreach, practice management, and reimbursement. Participants were concerned that pharmacists are not able to provide hormonal contraception for minors in our state and that a reimbursement mechanism has not yet been established. Engagement with large chain pharmacies and training all student pharmacists in the state were recommended as strategies to increase the number of pharmacist providers. Development of referral networks with health departments and other clinics was suggested to ensure patients are able to receive care that pharmacists are unable to provide (e.g., sexually transmitted disease screenings, long-acting reversible contraception). Opportunities for engaging with patients included creating a statewide marketing plan, conducting focus groups, and providing contraception services for college students. Partnerships with commercial payers and Medicaid to develop a reimbursement model for clinical services was deemed critical to success.

Conclusions: An interprofessional contraception summit generated recommendations to enhance provision of pharmacist-initiated hormonal contraception services in a state with a new statewide protocol. Qualitative themes for next steps in service implementation included advocacy for minors, community partnerships, birth control pharmacist workforce, patient outreach, practice management, and reimbursement.