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| Helping pharmacy & health communities improve access to Emergency Contraception (EC) |
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AlaskaPRAMS data gathered in the late 1990’s showed that 42 percent of all pregnancies in Alaska were unintended. A loose coalition, led by an OB/GYN in Anchorage, formed to increase public awareness of and access to emergency contraception. Representatives included members of the State Health Department, Planned Parenthood and other local organizations, Out of this coalition, the Alaska Emergency Contraception Project (AKECP) was created with the mission to improve EC education and access. In April 2001, the Alaska State Board of Pharmacy adopted general regulations permitting pharmacists to establish collaborative practice agreements with prescribers. In Alaska, both physicians and advance practice nurses have prescriptive authority and can sign protocols with pharmacists. The new regulations allowed pharmacists to initiate, modify and discontinue drug therapy under protocol with a prescriber. In the same year, to help promote awareness of EC in the pharmacy community, AKECP arranged for Don Downing, a pharmacist trainer from Washington State, to provide EC training. In April 25,2002, the Board of Pharmacy approved the first collaborative protocols enabling pharmacists to dispense EC in collaboration with a licensed prescriber. AKECP developed support documents for pharmacists to use including:
In 2003 AKECP, began working with Dr.Terry Babb, a clinical pharmacist whose hospital practice involves collaboration with physicians on a daily basis. In addition, Terry has been involved with the Alaska Pharmacists Association and is a well-known figure in Alaska’s pharmacy community. His professional work and involvement are essential for pharmacist recruitment and technical support. Early public awareness efforts consisted of various radio public service announcements, and booths at the Alaska Women’s Show, the state fair and other locations. The media also announced that local pharmacies would start dispensing EC after the first protocol was approved. Alaska’s remote, and often extremely isolated, communities present special logistical problems not shared by most states. For example, pharmacists generally receive their EC training through an American Pharmacists Association distant learning program on EC. Parts of Alaska are also deeply conservative which has slowed pharmacist recruitment. Some pharmacists may be hesitant due to real or perceived community backlash and internal pressure. On March 12, 2003 new legislation (SB138) was introduced that would annul pharmacy regulations that allow for collaborative practice. The bill has support from anti-choice legislators. Some physicians are concerned they will be removed from the EC process, and that their concerns were not addressed when the Board of Pharmacy adopted new collaborative drug therapy management regulations. The Alaska Pharmacists Association is currently working to increase awareness among legislators, physicians, and the public on the benefits of collaborative drug therapy management. State watchers were encouraged when the State Pharmacy Board, with its new appointees, approved an additional EC protocol in July 2003. It is expected that more EC protocols will be submitted for approval before the new legislation session starts in January 2004 Currently, 11 pharmacies have been approved as EC providers. Seven of the 11 are located in Anchorage, where half of the state’s population lives within a 50-mile radius. Three other EC pharmacies are located in North Pole, Sitka and Fairbanks. These numbers may seem small, but only 19 communities in Alaska even have pharmacies, and about a quarter of these communities now provide EC service! Pharmacies offering service in Alaska include independents, two chain pharmacies, and a Native American medical center.
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