Pharmacist-Prescribed Hormonal Contraception in North Carolina: An Early Adopter Pilot Study

In 2021, North Carolina (NC) authorized pharmacists to initiate hormonal contraceptives. The objectives of this pilot study were to: (1) determine where hormonal contraception (HC) services were provided; (2) evaluate patient characteristics; and (3) describe pharmacist interventions. Pharmacists who completed training and prescribed HC between April 2022 and December 2023 were invited to participate. Participants completed an online survey about pharmacy demographics and descriptive statistics were used to summarize characteristics. De-identified patient encounters were uploaded into a secure website and data was analyzed using descriptive statistics. 1309 pharmacists completed HC training. Seventeen pharmacists (1.3%) participated in the study and completed demographic surveys. Four pharmacists (24%) saw 34 patients during the study period and provided intervention data for 21 patients. Seventy percent of pharmacists worked in independent pharmacies, and 47% of pharmacies were in rural communities. Seventy percent of patients had commercial insurance (50%) or NC Medicaid (20%). Fifty-three percent of patients reported that they had a primary care provider (PCP). Pharmacists prescribed a hormonal contraceptive in 95% of patient encounters, most frequently the combined HC pill (70%). One patient was referred to a primary care clinic due to elevated blood pressure. All pharmacists in this early-adopter pilot study of contraception pharmacists practiced in independent pharmacies. Seventy percent of patients who sought care from a pharmacist were insured, approximately half did not have a primary care provider, and pharmacists initiated HC for 95% of patients. The most common HC prescribed was the combined HC pill.