Soon, pharmacists will offer more help to patients

http://www.modbee.com/opinion/opn-columns-blogs/article59390669.html

Since Oct. 1, California and Oregon have been in the process of implementing a law allowing women to obtain birth control directly from pharmacists. This law is taking effect during a controversial time for pharmacists.

In Cosmopolitan magazine last year, writer Haley Potiker detailed being denied the abortion pill by a CVS pharmacist. Potiker called the pharmacist’s behavior cold, quoting her saying, “There’s nothing I can do” and walking away “without a word.”

The pharmacist, Potiker explains, “didn’t feel like giving (me) the medication” despite a doctor’s prescription that included a warning that failing to take it in time would be risky.

There have been many similar documented instances of women being “reprimanded” by pharmacists for requesting oral contraceptives. It happened to me.

I attended Beyer High School. At 16, I was diagnosed with polycystic ovary syndrome and my pediatrician prescribed Yaz, both a birth-control pill and the main treatment for my condition. I will never forget when my mother tried to get the prescription filled and the pharmacist asked, “Do you even know what this is for?” then, “Why are you trying to get this for your daughter?”

At the time, I never considered that I might one day be in that pharmacist’s shoes.

Some people outside the health-care community are encouraging a few pharmacists to refuse to fill certain prescriptions. This is not good for future interactions between pharmacists and patients.

The National Women’s Law Center, which advocates for women’s rights, has written a “Pharmacy Refusals 101” guide in which it advises women to “file a complaint with the state’s pharmacy board to get sanctions against the pharmacist or pharmacy.”

Others have recommended not returning to the pharmacy and telling the community of such negative experiences. In reality, few patients seek media attention or other remedies.

Actually, judgment calls by pharmacists can be extremely useful in many instances – from preventing life-threatening medication errors to fighting the battle against prescription drug abuse. Only a small minority of pharmacists refuse to dispense medications for religious or moral reasons.

As a member of the pharmacy community, it is disheartening whenever a pharmacist is portrayed as not exhibiting commitment or compassion or violating the codes of ethics and evidence-based practices that govern our profession. To get our white coats, all pharmacists take an oath to embrace and advocate changes that improve patient care.

In Gallup polls, pharmacists have been ranked among the nation’s most trusted professionals – ahead of doctors and behind only nurses. Honesty and adherence to the highest ethical and moral standards have always been a cornerstone of our profession. In recent years, one of our highest priorities has been patient-centered care.

The future of community pharmacies encompasses medication therapy management, which optimizes drug therapy and improves therapeutic outcomes.

Despite our training, expertise and trustworthiness, pharmacists are not recognized as health-care providers under federal law. The American Pharmacists Association is campaigning to gain “provider” status, allowing pharmacists to prescribe medications in some cases.

Pharmacists possess the training and knowledge to support women’s health through education and providing medication, particularly in areas where access to primary health care is limited. Pharmacists are often the first health-care professionals to whom people turn for advice. Because they’re available in retail establishments, pharmacists have a higher degree of accessibility. Our training on reproductive issues, safety and proper use of contraceptives is comprehensive, and our communication skills have been honed for quick and convenient intervention.

Under the FDA’s watchful eye since 2006, pharmacists have been successfully providing emergency contraceptives and crucial counseling. With new laws, pharmacists will be able to provide services once restricted to doctors’ offices without increased costs to consumers.

Oregon and California pharmacists will have to complete supplemental training. Though care might be more generalized, it will meet the needs of a vast majority. Our basic protocol will dictate that those requiring specialized care and screenings will be referred to gynecologists. As medication experts on a community’s front lines, pharmacists have the ability to educate on health issues and to clarify commonly misunderstood medical terms.

One area of concern is abortion, one of the most commonly performed medical procedures in America. A “medical” abortion uses medications instead of surgery and is only available during the first nine weeks of pregnancy. The “abortion pill” is a two-step medication regimen.

At Planned Parenthood centers, the first medication is administered on-site. For the second medication, patients are given a prescription to be filled at a pharmacy. It must be taken from 24 to 48 hours after the first.

The “abortion pill” is different from “emergency contraception.” Emergency contraception is a broad term for medications that might prevent pregnancy by either preventing ovulation, preventing an egg from being fertilized, or preventing a fertilized egg from attaching to the uterine wall. Such medication is often called the “morning-after” pill – but that can be misleading.

Any pharmacist will tell you the morning after, or Plan B, pill should be taken immediately after unprotected sex or the failure of other birth-control measures; waiting until the “morning after” can be too late. Emergency contraception is not only available as a pill; it also can occur with an IUD containing copper, which is an effective emergency and long-term contraceptive.

It is estimated there are 6.6 million unintended pregnancies annually. The abortions that often follow are preventable and costly. The economic impact of abortion since 1970 has been estimated at $35 trillion to $70 trillion. Pharmacists can make an enormous economic and social impact by making contraception and health education more accessible.

Regardless of personal opinions on unplanned pregnancy, reducing the abortion rate is worthy of our attention and efforts. Women should not have to resort to invasive or inconvenient options.

Pharmacists and patients will soon be able to work hand-in-hand to achieve desirable goals for women’s health. This is a strong relationship that will stand the test of time as pharmacists make judgment calls to help and protect Americans.

Even when put in the shoes of that Modesto pharmacist, we are ultimately committed to what is in the patient’s best interests.

Filed under: General Problems