(1354) Community Pharmacists and Improving Contraception Access: relationships Between Contraceptive Counseling and Dispensing Contraceptives

Objectives: Experiences of contraceptive counseling and obtaining contraceptives vary for women of childbearing age based on education level, race, ethnicity, and health insurance. Community pharmacists are playing a greater role in improving contraceptive access as more states implement direct pharmacy access policies that allow for community pharmacists to prescribe contraceptives. Our study sought to provide more information on the groups of women that community pharmacists should focus their outreach on when offering contraceptive counseling and prescribing contraceptives. Our first aim was to determine how patient education level, race, ethnicity, insurance, and patient-provider race concordance influenced the likelihood of receiving contraceptive counseling. The second aim was to determine how receiving contraceptive counseling influenced the likelihood of being dispensed contraceptives by a pharmacist.

Methods: Data for this study were obtained from the Medical Expenditure Panel Survey-Household Component (MEPS-HC) consolidated data file and prescribed medicines file for 2020. Our sample consisted of women between the ages of 18 and 49, who answered questions regarding marital status, education level, race, ethnicity, their provider’s race, insurance status, and whether they had received contraceptive counseling from their primary care provider in the past 12 months to be included in our study. Initial bivariate relationships between contraceptive counseling and all other covariates were assessed using Pearson chi-square tests. Logistic regression models were used to (a) estimate which covariates had significant associations with the likelihood of receiving contraceptive counseling and (b) to estimate the association between contraceptive counseling and the likelihood of being dispensed contraceptives while controlling for the same covariates.

Results: Our sample included 1,093 women of reproductive age, 270 of which received contraceptive counseling. Of these 270 women, 37.4% were dispensed contraceptives. Women between the ages of 38 and 49 and those insured through Medicaid were less likely to receive contraceptive counseling. Additionally, pharmacist-patient race concordance had no influence on likelihood of receiving contraceptive counseling. Counseling and education level were strong predictors of being dispensed contraceptives. Race, ethnicity, Medicaid, and marital status were negatively associated with being dispensed contraceptives.

Conclusions: Inequities exist in access to contraceptive care for women of diverse racial, ethnic, and educational backgrounds as well as those insured through Medicaid. As direct pharmacy access to contraceptives becomes more common across states, pharmacies and pharmacists will need to implement outreach and communication strategies that are informative and welcoming for a diverse population of women. Future research can determine how pharmacies and pharmacists should develop communication and marketing strategies to inform women on contraceptive prescribing services in a way that is inclusive and welcoming, as currently no literature exists on this subject. Pharmacists should view the growing implementation of direct pharmacy access policies for contraceptives as an opportunity to provide contraceptive care to women who are often left out of the current health care system with regards to contraceptive access.