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| Helping pharmacy & health communities improve access to Emergency Contraception (EC) |
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WashingtonIn 1997, Washington, like a handful of other states, had an optimal environment for allowing pharmacists to provide EC. Washington’s pharmacy practice act needed no regulatory or statutory change to allow pharmacists to provide EC directly to the community. For almost 20 years, pharmacists in Washington have been able to initiate therapy under signed protocols with a prescriber and the Board of Pharmacy currently has protocols on file for more than 550 pharmacists covering a wide variety of conditions and diseases. Further, collaborative practice agreements in Washington cover the named pharmacist and all other pharmacists who work with this individual — an important feature that has not yet been replicated in other states. The story of how Washington pharmacists began to provide EC is an interesting one and shows how larger movements often have serendipitous beginnings. Jackie Gardner, a professor with the University of Washington, School of Pharmacy was tasked with writing a monthly CE piece for pharmacists. Dr. Gardner selected emergency contraception, specifically, an adaptation of a general review prepared by the Program for Appropriate Technology in Health (PATH). The Northwest Emergency Contraception Coalition had been formed in Washington to promote access to EC, but had not yet considered pharmacist prescribers. Until, that is, Dr. Gardner’s article clearly stated the logic behind the distribution of EC through pharmacies and that Washington laws were supportive of such activities. PATH officer Jane Hutchings, read an advance publication and responded with action. PATH quickly received funding from the Packard Foundation and in 1997 launched the two-year Emergency Contraception Collaborative Agreement Pilot Project to allow direct pharmacy access to EC. The advisory committee to the project included an impressive list of representatives from federal, state and county health service agencies, the state legislature, a woman’s law center, the Board of Pharmacy, the Washington State Pharmacy Association (WSPA), and individual physicians and pharmacists. Support from the medical community in Washington was very positive, and the Washington State Medical Association passed a resolution in support of the pilot project that opened with the following statement: “RESOLVED, that the Washington State Medical Association supports the pilot that allows retail pharmacists in Washington to dispense emergency contraceptive directly to patients under a prescriptive protocol, with a local physician advisor.” Pharmacists taking part in the pilot received CE training by WSPA trainers such as Don Downing, on all aspects of EC provision. When pharmacists submitted signed collaborative agreements to the Board of Pharmacy, Board staff forwarded the information to the national hotline, 1-888-not-2-late. In the 10 months following the launch, pharmacists associated with 128 pharmacies provided EC on more than 7,000 occasions. The highly successful pilot project end in 1999 and has since then become self-sustaining. As the first state in the country to directly distribute EC through pharmacies, it has served as an inspiring model for other states including California, Alaska, New Mexico and Hawaii.
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