46: Contraception Prescribing

Question 1

Documentation and records

Answer 1

-must keep as hard copy or digital format that is easily accessible:

-current copy of state protocol
-certificate of training completion
-documentation of all assessments and plans for seven years
-also obtain an NPI

Question 2

Documentation and records for patients

Answer 2

-provide pt record of contraception prescribed
-refer to PCP or women’s health provider
-notification of PCP is NOT required but may be helpful

Question 3

What pharmacists can NOT prescribe

Answer 3

-IM form of depo (not SC)
-IUD

Question 4

Pharmacist conscience clause

Answer 4

-refusal to fill prescription on religious or moral grounds
-some states have laws allowing pharmacists to refuse to fill
-some states have laws requiring pharmacists to fill

Question 5

Approaches to contraceptive counseling

Answer 5

-tiered effectiveness
-reproductive life planning
-one key question
-PATH
-shared decision making
-others

Question 6

Tiered effectiveness approach

Answer 6

-show the efficacy chart

Question 7

Reproductive life planning approach

Answer 7

-whether, when, and how to have children
-based on priorities, resources, and values
-comprehensive and culturally appropriate

Question 8

One key question approach

Answer 8

-would you like to become pregnant in the next year?

Question 9

They would like to become pregnant in the next year

Answer 9

-assess and care based on core preconception factors
-folic acid supplementation

Question 10

They would NOT like to become pregnant in the next year

Answer 10

-discuss current method, satisfaction, and accurate use
-discuss all available options

Question 11

They don’t know if they want kids in the next year

Answer 11

-pregnancy ambivalence = more likely to not be using contraception or to discontinue use
-determine appropriate intervention
-follic acid supplementation if potential for pregnancy

Question 12

PATH approach

Answer 12

-Parenting/Pregnancy attitudes
-Timing
-How important delaying pregnancy is

Question 13

Questions to ask PATH approach

Answer 13

-do you think u might like to have kids at some point
-when
-how importnant is preventing pregnancy until then

Question 14

Shared-decision making approach

Answer 14

-inc knowledge
-more confidence
-more active involvement
-selection of more conservative treatment

Question 15

Shared-decision key steps

Answer 15

-inform that options are available
-provide more detailed info about options
-support consideration of preferences and decision

Question 16

Contraceptive coercion

Answer 16

-promoting LARCs as best
-racial targeting
-decision aids
-pressure to select
-incomplete discussion of side effects

Question 17

Benefits of satisfaction with contraceptive choice

Answer 17

-less likely to use incorrectly
-prevent unwanted pregnancy
-catalyst for opportunity

Question 18

Factors that inc continuation rates

Answer 18

-more likely if above poverty level and college education
-higher interpersonal quality of care
-elicit pts perspective

Question 19

Decision making processes

Answer 19

-inc satisfaction
-develops positive relationship for young pts w healthcare
-negative experience may impact future access and use

Question 20

Chosen method

Answer 20

-provider preference = less satidfaction
-implicit pressure = discontinuation

Question 21

limiting coercion in contraceptive choice

Answer 21

-present all options w pros/cons
-visual decision aids to independently review
-awareness of biases