Implementation of support tools to promote safety in the prescribing of oral contraceptives

摘要 尽管发现了第一种组合，但美国近一半的怀孕都是意外的 20世纪60年代的激素避孕药。荷尔蒙避孕药是一种有效且成本效益高的策略 降低意外怀孕率。缺乏获得避孕服务的机会，特别是青少年， 少数群体妇女和社会经济地位较低的妇女造成了严重的健康和财务不平等 并导致美国政府的巨额支出。药剂师处方的避孕服务有 有可能增加获得护理的机会，减少美国意外怀孕的数量。药剂师 都表示有兴趣提供避孕服务，但列举了目前存在的几个障碍 来阻碍他们的扩张。对于药剂师处方避孕服务的广泛增长，一个 需要解决目前存在的障碍的一揽子实施方案。一种特定的避孕药 电子健康记录系统，提高了效率，整合了护理点工具，并且负担得起 成为成功实施一揽子计划的基础。OvaryIt是一家总部位于佛罗里达州的小企业， 开发了专有的符合HIPAA标准的避孕药具专用平台，用于提供直接面向消费者的 远程医疗服务。我们建议调整这一平台，作为全面 实施一揽子扩大亲自药剂师开出的避孕药具服务。第一阶段将支持 研究调查这种解决方案的可行性并建立概念验证。目标1：开展需求 评估以确定操作要求。这将产生项目文档和路线图 需要在现有的药房管理系统中整合避孕功能。目标2： 完成了对20名药剂师最终用户的研究，将OvaryIt平台与当前的标准论文进行了比较 绘制图表的过程。每个药剂师将完成两次标准化的避孕药患者会面，一次使用 每一道工序。结果将包括完成会面的时间、遵守USMEC 指导方针、适当的处方选择和定量调查数据。目标3：组织一个焦点小组， 药剂师最终用户和管理利益相关者讨论感知的力量和质量 针对每个已确定的实施成功的障碍或痛点提出项目解决方案。在最后 在第一阶段，OvaryIt，LLC将有一个全面实施包的路线图，其中包括经过审查的解决方案 目前阻碍采用药剂师处方避孕服务的障碍很多。阶段 二、将作出努力，以便制定一套全面的执行方案，以便广泛使用 向独立、大型连锁和基于卫生系统的药店商业化。巨大的市场 OvaryIt、LLC和参与的药房有机会创造新的收入机会，同时 极大地扩大了美国获得避孕药具的机会。

Summary Nearly half of the pregnancies in the United States are unintended despite the discovery of the first combination hormonal contraceptive in the 1960s. Hormonal contraceptives are an efficacious and cost-effective strategy to decrease the rate of unintended pregnancy. Lack of access to contraceptive services, especially for adolescents, minority women, and women of lower socioeconomic status creates significant health and financial inequities and leads to significant US government expenditures. Pharmacist-prescribed contraceptive services have the potential to increase access to care, decreasing the number of unintended pregnancies in the US. Pharmacists have expressed interest in providing contraceptive services but have cited several barriers that currently serve to hinder their expansion. For the widespread growth of pharmacist-prescribed contraceptive services, an implementation package is needed that addresses the barriers that currently exist. A contraceptive-specific Electronic Health Record system that increases efficiency, incorporates point-of-care tools, and is affordable will be the foundation of a successful implementation package. OvaryIt, a Florida-based small business, has developed a proprietary HIPAA-compliant contraceptive-specific platform for the provision of direct-to-consumer telehealth services. We propose to adapt this platform to serve as the foundation of a comprehensive implementation package to expand in-person pharmacist-prescribed contraceptive services. Phase I will support studies to investigate the feasibility and establish a proof-of-concept of such a solution. Aim 1: Conduct a needs assessment to determine operational requirements. This will result in project documentation and the roadmap needed to integrate contraceptive functionality within existing Pharmacy Management Systems. Aim 2: Completion of a study of 20 pharmacist end-users comparing the OvaryIt platform to the current standard paper charting process. Each pharmacist will complete two standardized contraceptive patient encounters, one utilizing each process. Outcomes will include time to completion of the encounter, compliance with the USMEC guidelines, appropriate prescription selection, and quantitative survey data. Aim 3: Conduct a focus group with pharmacist end-users and administrative stakeholders to discuss the perceived strength and quality of the proposed project solutions for each of the identified barriers or pain points to implementation success. At the end of Phase I, OvaryIt, LLC will have a roadmap for a comprehensive implementation package with vetted solutions for the many barriers that currently prevent the adoption of pharmacist-prescribed contraceptive services. Phase II efforts will allow for the creation of a comprehensive implementation package ready for widespread commercialization to independent, large chain, and health system-based pharmacies. A tremendous market opportunity exists for OvaryIt, LLC and participating pharmacies to create new revenue opportunities while significantly expanding access to contraceptives in the US.