Louisiana Pharmacies' Availability of Emergency Contraception and Counseling Accuracy to Adolescent and Physician Callers

J Pediatr Adolesc Gynecol. 2021 Oct;34(5):693-698. doi: 10.1016/j.jpag.2021.02.102. Epub 2021 Feb 22.

Abstract

Study objective: Adolescents face many barriers to obtaining emergency contraception (EC), despite it being an approved and recommended method to prevent unintended pregnancy. This study examined pharmacy-related barriers to adolescents' access to EC in Louisiana.

Design: Prospective, telephone-call secret shopper study to pharmacies to assess same-day EC availability and barriers to purchase.

Setting: A total of 182 pharmacies in 5 Louisiana cities.

Participants: Responses provided by pharmacists or other pharmacy staff assessed between July 2018 and November 2019.

Interventions: Collected data from secret shopper phone calls and compared responses provided to callers between male and female callers and physician and adolescent callers.

Main outcome measures: Same-day levonorgestrel (LNG) availability, same-day ulipristal acetate (UPA) availability, age restrictions on purchase, requirement of parental consent for purchase, and type of staff member that advised the caller.

Results: Of 364 calls to 182 pharmacies, 66% of pharmacists or other pharmacy staff reported same-day LNG access and 5% reported same-day UPA access. An inaccurate age restriction regarding EC purchase was reported in 15% of calls. Female callers were cited this age restriction more frequently than their male counterparts (20% vs 10%). Pharmacists were more likely than other pharmacy staff to counsel female callers compared to male callers (52% vs 27%) and physician callers compared to adolescents (50% vs 30%).

Conclusions: Many pharmacies in Louisiana have limited same-day availability of EC and often report inconsistent and inaccurate age and consent regulations for its use. Continued outreach and education to pharmacies is necessary to address these barriers to adolescent EC access.

Keywords: Adolescent; Adolescent medicine; Adolescent pregnancy; Emergency contraception; Health equity.