Stakeholders’ perspectives on barriers and facilitators in dispensing hormonal contraceptives by community pharmacist: an exploratory study

Abstract

Unintended pregnancy imposes a critical global health, social and economic burden. It was estimated about one-third of unintended pregnancies in Southeast Asia were due to low use of contraception, contraceptive method failure, and high unmet need for contraceptives. This study explored the current practices and issues in dispensing hormonal contraceptives in community pharmacy settings in Malaysia. An in-depth qualitative study using semi-structured interviews was conducted among the stakeholders consisting of community pharmacists, general practitioners, Obstetrics and Gynaecology (O&G) specialists, medical officers and pharmacists from the Ministry of Health. Eighteen participants were recruited using purposive sampling. The interviews were completed when saturation was achieved and analysed using an inductive approach to identify themes, whereby emerging themes were coded and grouped into categories. Three themes were identified: healthcare professional factors, consumer factors and system factors. Community pharmacists should anticipate challenges in dispensing contraceptives mainly attributable to a lack of training and guidelines or standardisation.

Keywords

• community pharmacist
• dispensing contraceptives
• issues and challenges

References

1. [1] S. M. I. Hossain, M. E. Khan, M. M. Rahman, and M. P. Sebastian, “Population Council Population Council Knowledge Commons Knowledge Commons 2005 Emergency Contraceptive Pills: South East Asia Regional Training Emergency Contraceptive Pills: South East Asia Regional Training Manual Manual,” 2005, Accessed: Sep. 24, 2024. [Online]. Available: http://www.popcouncil.org/frontiers/
2. [2] M. Yusof, A. Abdul Samad, M. Omar, and N. A. Ahmad, “Unplanned Pregnancy and Its Associated Factors,” Glob J Health Sci, vol. 10, no. 8, p. 132, Jul. 2018, doi: 10.5539/GJHS.V10N8P132.
3. [3] R. M. Elkalmi et al., “Knowledge, awareness, and perception of contraception among senior pharmacy students in Malaysia: A pilot study,” J Res Pharm Pract, vol. 4, no. 2, p. 94, 2015, doi: 10.4103/2279-042X.155760.
4. [4] S. A. R. Abdel-Haleem, H. A. R. Amasha, and N. S. Salama, “UNINTENDED PREGNANCY AND FAMILY PLANNING COUNSELING GUIDELINE ON MATERNITY NURSES’ PERFORMANCE: CLINICAL BASED STUDY,” The Malaysian Journal of Nursing (MJN), vol. 10, no. 3, pp. 99–111, Jan. 2019, doi: 10.31674/MJN.2019.V10I03.014.
5. [5] E. Inaoka, S. Wakai, Y. Nakamura, Y. Al Babily, and A. A. R. Saghayroun, “Correlates of visit regularity among family planning clients in urban Yemen,” Advances in Contraception, vol. 15, no. 4, pp. 257–274, 1999, doi: 10.1023/A:1006728021465/METRICS.
6. [6] “Medical eligibility criteria for contraceptive use,” 2015, Accessed: Sep. 24, 2024. [Online]. Available: www.who.int
7. [7] “Lesson: Prescribing Oral Contraceptives: A New Pharmacist Role.” Accessed: Sep. 24, 2024. [Online]. Available: https://journalce.powerpak.com/ce/prescribing-oral-contraceptives-a-new
8. [8] “MyGOV - The Government of Malaysia’s Official Portal.” Accessed: Sep. 23, 2024. [Online]. Available: https://www.malaysia.gov.my/portal/subcategory/1613

9. [9] C. Marshall, A. Nuru-Jeter, S. Guendelman, J. Mauldon, and T. Raine-Bennett, “Patient perceptions of a decision support tool to assist with young women’s contraceptive choice,” Patient Educ Couns, vol. 100, no. 2, pp. 343–348, Feb. 2017, doi: 10.1016/J.PEC.2016.08.022.
10. [10] L. A. Sweeney et al., “A Qualitative Study of Prescription Contraception Use: The Perspectives of Users, General Practitioners and Pharmacists,” PLoS One, vol. 10, no. 12, Dec. 2015, doi: 10.1371/JOURNAL.PONE.0144074.
11. [11] V. Braun and V. Clarke, “Using thematic analysis in psychology,” Qual Res Psychol, vol. 3, no. 2, pp. 77–101, 2006, doi: 10.1191/1478088706QP063OA.
12. [12] A. Tong, P. Sainsbury, and J. Craig, “Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups,” Int J Qual Health Care, vol. 19, no. 6, pp. 349–357, Dec. 2007, doi: 10.1093/INTQHC/MZM042.
13. [13] A. Glasier, J. Scorer, and A. Bigrigg, “Attitudes of women in Scotland to contraception: a qualitative study to explore the acceptability of long-acting methods,” J Fam Plann Reprod Health Care, vol. 34, no. 4, pp. 213–217, Oct. 2008, doi: 10.1783/147118908786000497.
14. [14] E. Okpo, L. Allerton, and S. Brechin, “‘But you can’t reverse a hysterectomy!’ Perceptions of long acting reversible contraception (LARC) among young women aged 16-24 years: a qualitative study,” Public Health, vol. 128, no. 10, pp. 934–939, 2014, doi: 10.1016/J.PUHE.2014.08.012.
15. [15] J. Bracken and C. A. Graham, “Young women’s attitudes towards, and experiences of, long-acting reversible contraceptives,” Eur J Contracept Reprod Health Care, vol. 19, no. 4, pp. 276–284, 2014, doi: 10.3109/13625187.2014.917623.
16. [16] J. Kibicho and J. Owczarzak, “A patient-centered pharmacy services model of HIV patient care in community pharmacy settings: a theoretical and empirical framework,” AIDS Patient Care STDS, vol. 26, no. 1, pp. 20–28, Jan. 2012, doi: 10.1089/APC.2011.0212.
17. [17] M. I. Rodriguez, F. M. Biel, J. J. Swartz, L. Anderson, and A. B. Edelman, “Pharmacists’ experience with prescribing hormonal contraception in Oregon,” J Am Pharm Assoc (2003), vol. 58, no. 6, pp. 608–613, Nov. 2018, doi: 10.1016/J.JAPH.2018.06.020.
18. [18] M. Rafferty, “Prevention services in primary care: taking time, setting priorities.,” Western Journal of Medicine, vol. 169, no. 5, p. 269, 1998, Accessed: Sep. 24, 2024. [Online]. Available: /pmc/articles/PMC1305315/?report=abstract
19. [19] T. E. Kottke, M. L. Brekke, and L. I. Solberg, “Making ‘Time’ for Preventive Services,” Mayo Clin Proc, vol. 68, pp. 785–791, 1993, doi: 10.1016/S0025-6196(12)60638-7.
20. [20] S. H. Scholle, J. C. Chang, J. Harman, and M. McNeil, “Trends in women’s health services by type of physician seen: Data from the 1985 and 1997-98 NAMCS,” Women’s Health Issues, vol. 12, no. 4, pp. 165–177, 2002, doi: 10.1016/S1049-3867(02)00139-1.
21. [21] S. S. Brown, L. Burdette, and P. Rodriguez, “Looking inward: provider-based barriers to contraception among teens and young adults,” Contraception, vol. 78, no. 5, pp. 355–357, Nov. 2008, doi: 10.1016/J.CONTRACEPTION.2008.07.021.
22. [22] A. Y. Akers, M. A. Gold, S. Borrero, A. Santucci, and E. B. Schwarz, “Providers’ Perspectives on Challenges to Contraceptive Counseling in Primary Care Settings,” J Womens Health, vol. 19, no. 6, p. 1163, 2010, doi: 10.1089/JWH.2009.1735.