Evidence suggests that unintended pregnancy disproportionately affects women under the age of 24 in the United States. We know that one of the most effective approaches for reducing the rate of unintended pregnancies among this population is expanding access to contraceptives. However, for most women in the U.S., contraceptives are available only after a visit to a health care provider, usually a physician or advanced practice provider.
A few states have passed legislation allowing pharmacists to prescribe and dispense hormonal contraceptives, but pharmacists tend to be uncomfortable providing these services to youth, which is an important population to reach. Therefore, there is a need to assess the impact of pharmacist prescribing for adolescents and fill this anticipated gap in services for youth.
To address this issue, our team plans to develop and test a unique telemedicine system that simulates pharmacist prescribing and dispensing of contraceptives to adolescent women through medication dispensing machines, or MedStations. We will do this by capitalizing on an existing collaboration between Children’s Hospital of Philadelphia (CHOP) and Stellar Rx, a specialty pharmacy that operates MedStations, which allows clinicians to dispense contraceptives to youth the day they are seen. By building on this existing infrastructure and refining the MedStation to serve as a telemedicine platform, patients, pharmacists and clinicians can communicate among one-another in real-time to ensure safe medication dispensing.
We will build this e-platform interface from a design plan developed by the CHOP Digital Health team. We first plan to recruit five adolescents ages 14 to 17 years to engage with the prototype and give us feedback on the ease of use, design aspects, etc. After we collect data to inform revisions, we will build an electronic version of the e-platform.
We will then recruit 20 participants to pilot test the telemedicine e-platform. Upon activating, patients will complete a demographic and medical screening questionnaire that assesses age, insurance, contraceptive use history, items capturing pregnancy risk, etc. The platform will ask patients to identify a contraceptive method they wish to start and provide contraceptive education sheets, if needed. After the participant selects a contraceptive method, data from the self-screening tool will be sent electronically to a Stellar Rx pharmacist, who will be trained by our team members.
Lastly, the pharmacist will review the self-screening tool and complete a Pharmacist Assessment Form that indicates whether they would prescribe the contraceptive and approve dispensing. If the pharmacist has any questions, they may contact the patient or consult one of our team members who are contraceptive experts. It’s important to note that no actual dispensing will occur from the MedStations—patients will receive contraception from clinicians during their scheduled clinic visit.
We hope that pilot data from this project can help inform best practices for pharmacist prescribing of contraceptives to adolescents so that youth have the supports they need to practice safe sexual behaviors. Additionally, findings from this study could potentially inform future state-based legislation to allow for telemedicine options for this type of pharmacist prescribing.
Children's Hospital of Philadelphia, PolicyLab. Piloting a Telehealth Platform to Improve Teen Contraceptive Access by Simulating Pharmacist Prescribing [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here].