(306) Increasing Access to Hormonal Contraception through Pharmacist-Initiated Contraception in North Carolina

Objective : The objective of this work was to advocate for the role of the pharmacist in reproductive health care and pass legislation allowing pharmacists to initiate hormonal contraception.

Methods: The UNC Eshelman School of Pharmacy partnered with the North Carolina Association of Pharmacists (NCAP) to establish a Task Force on Hormonal Contraception to provide recommendations for legislation, training, and implementation of pharmacist-initiated contraception. Members included pharmacy faculty from all four schools and colleges of pharmacy in NC, community pharmacists, and student pharmacists. Faculty and students advocated for improving access to reproductive healthcare services by engaging with leaders including medical societies, reproductive health stakeholders, and legislators. Strategies for advocating for the role of the community pharmacist were incorporated into the Doctor of Pharmacy curriculum and the co-curriculum.

Results: Survey results indicated that 83% of community pharmacists in NC had interest in providing hormonal contraception services. Bipartisan legislation was passed into law into 2022, and the NC Boards of Pharmacy and Medicine created standing orders that were signed by the State Health Director. The state association created a training program that was funded by the NC Board of Pharmacy. NC pharmacists are now allowed to initiate combined oral and transdermal hormonal contraception, progestin only pills, and folic acid as a strategy to increase access to care, decrease unintended pregnancies, and improve maternal mortality. Approximately 1500 pharmacists have completed the NCAP training program and early adopters have begun providing contraception services across the state.

Conclusions: Engagement between UNC Eshelman School of Pharmacy, other schools and colleges of pharmacy in NC, our state association, reproductive health stakeholders, and student pharmacists led to new legislation that allows pharmacists to initiate hormonal contraception.