June 24, 2015
Protocols Drafted to Allow CA Pharmacists to
Provide Birth Control

Sacramento—If all goes as planned, California pharmacists soon should be able to administer birth control and several other types of preventive therapies without a doctor’s prescription.

Although passed 2 years ago, the new law, SB 493, is expected to fully go into effect as early as October 1st this year. The state pharmacy board recently finalized protocols for implementation, but those have to be reviewed for legal and budgetary approval by multiple state agencies.

Once the protocols are in place, pharmacists will be able to prescribe hormonal contraceptives, including birth control pills, skin patches and vaginal rings, although an intrauterine device will still require a physician’s prescription.

Under the category of preventive services for major health issues, pharmacists will be able to provide prescription-strength inhalers; gums and lozenges for nicotine addiction; and medication for foreign travel, including vaccinations and antibiotics. The law also authorizes all licensed pharmacists to administer drugs and biologics by injection when ordered by a prescriber; provide consultation, training, and education about drug therapy, disease management, and disease prevention; participate in multidisciplinary review of patient progress, including appropriate access to medical records; and order and interpret tests to monitor and manage the efficacy and toxicity of drug therapies, in coordination with the patient’s prescriber.

The recently drafted protocols for pharmacists to provide self-administered hormonal contraception require that pharmacists ask the patients to use and complete a self-screening tool; review the self-screening answers and clarify responses if needed; and measure and record the patient’s seated blood pressure if combined hormonal contraceptives are requested or recommended. The form is required to be provided in alternate languages and to be stored for 3 years.

The pharmacist also should make sure the patient is appropriately trained in administration of the requested or recommended contraceptive medication, providing appropriate counseling and written information on the product, according to the draft protocols.

In addition, whether or not the hormonal contraceptive is provided to them, patients should be referred for follow-up care with a primary care provider or nearby clinic, according to the protocols. At the same time, the primary care provider must be informed of any drug or device provided to the patient.

Prior to furnishing self-administered hormonal contraception, pharmacists who participate in the process must have completed a minimum of 1 hour of a board-approved continuing education program specific to self-administered hormonal contraception.

Development of the new protocols is timely because at least one other state, Oregon, has a bill advancing in the legislature that would allow pharmacist prescribing of birth control.

California’s law, SB 493, which officially went into effect January 1, 2014 (although some provisions were delayed by pharmacy board review), goes far beyond the birth control provisions. It also establishes an Advanced Practice Pharmacist recognition.

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