Community Pharmacists' Roles in Sexual and Reproductive Health

  • Author / Creator
    Navarrete Martinez, Javiera Constanza
  • Over the past two decades, considerable progress has been made in advancing the global agenda to ensure accessible and high-quality sexual and reproductive health (SRH) services for everyone. Legislative and policy changes have enabled pharmacists to expand their scope of practice to address different and new health challenges. Globally, the pharmacist’s role is described as becoming more patient-oriented than it was years ago. Pharmacists’ roles in SRH have evolved from primarily dispensing and counselling to delivery of extended services such as prevention and screening, prescribing, and referral to other SRH providers. The objective of this thesis was to determine community pharmacists’ extended roles, practice experiences, and attitudes towards the provision of a wide range of SRH services. The first project, a scoping review of the literature, focused on synthesizing research that evaluated community pharmacists’ delivery of SRH services. The second study aimed to explore community pharmacists' practices, attitudes, and self-reported confidence towards the provision of SRH services in Alberta, Canada.
    The scoping review was completed by searching 6 databases and a grey literature web library from January 2007 to July 2020. After applying the eligibility criteria, 43 articles were included for analysis. Most studies were carried out in developed countries. Twenty-eight studies focused on sexually transmitted and blood-borne infections (STBBI), 12 on contraception, 2 in pregnancy, and 1 on sexual dysfunction. The main services provided by pharmacists were screening, prescribing, and provision of treatment through protocol or pharmacist only medications. Research included in the scoping review demonstrates that pharmacists’ roles have extended beyond dispensing practices, supported by legislation, technology, and partnerships. Delivery of SRH services by community pharmacists was considered feasible, but most importantly, highly accepted and valued by users. However, a number of barriers need to be considered and addressed to position community pharmacists as SRH providers.
    The second study was a cross-sectional web-based survey of community pharmacists practicing in Alberta (Canada) that explored practices, attitudes, perception of influencing factors, self-reported confidence in providing SRH education, and training preferences related to the provision of SRH services. In this study, the majority of participants reported currently dispensing medications and educating patients on several SRH topics. Participants were also providing initial prescribing, extension or renewal of prescriptions, and administering injections. Overall, participants had a positive attitude towards their role in providing SRH services. Participants’ characteristics, such as gender, country of first pharmacy degree, additional prescribing authorization, and type of pharmacy, were found to be significant predictors of providing some extended services. In addition, the number of services provided and the country of first pharmacy degree were significant and independent predictors of overall confidence in providing SRH education. Most participants (84%) expressed interest in additional training related to at least one SRH topic; STBBI, sexual health concerns of lesbian, gay, bisexual, transgender, queer (or questioning) and others (LGBTQ+), and abortion medications were the most commonly selected. These were the same SRH topics that a higher number of participants reported to feel not at all confident in providing patient education.
    The findings from both studies showed that community pharmacists are engaged in providing several traditional and extended SRH services. Inclusion of community pharmacists as SRH providers will help improve access within community settings. However, several challenges need to be addressed to implement pharmacy based SRH services and position community pharmacists as providers. This thesis highlights the opportunity to promote community pharmacists as members of the primary health care workforce to help address the SRH agenda.

  • Subjects / Keywords
  • Graduation date
    Spring 2021
  • Type of Item
  • Degree
    Master of Science
  • DOI
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.