Hospital-based program for increasing the availability of emergency contraception: Simulating nonprescription access

Purpose. A hospital-based program simulating nonprescription access to emergency contraception (EC) is described. Methods. A collaborative agreement between the pharmacy and therapeutics committee and the pharmacy department was initiated at a safety-net teaching hospital to provide EC to clinic patients directly from the hospital pharmacy without the need to first see a health care provider. EC was available 24 hours per day to any woman requesting it at the hospital pharmacy, with the collaborative agreement serving as the prescription. During clinic hours, patients were directed to the outpatient pharmacy to request EC. After hours, patients went to the emergency department triage desk and were directed to the inpatient pharmacy. Patients making inquiries about EC were encouraged to see their health care provider as soon as possible for counseling about contraceptive options. No specific program was initiated for publicizing the increased availability of EC, as it was assumed that health care providers and word-of-mouth would inform patients of this option. Results. The program was initiated in the fourth quarter of 2001. Total doses of EC dispensed increased nearly eightfold over the 1.5-year study period since the inception of this program. Most of this increase (81%) was attributable to the collaborative agreement. Twenty-eight percent of EC was dispensed outside of regular clinic hours. No patient complaints regarding this plan were received, and pharmacy staff did not believe that this program presented a significant additional burden to their workload. Conclusion. A collaborative agreement simulating nonprescription availability increased the use of EC in a hospital-based clinic setting.