“How Can a Pharmacist Help Me?”

Pharmacy Access Partnership Eases the Contraceptive Communication Gap for Teens

By Cathy Curtis

To young people who are used to shopping for makeup or munchies at the local drugstore, the pharmacy can be a mysterious, even off-putting place.

Focus groups with teenage girls from diverse ethnic backgrounds in California revealed the extent of the problem to Pharmacy Access Partnership (PAP), a center of Oakland-based Pacific Institute for Women’s Health (PIWH). Only 15 percent of the teens knew they could obtain emergency contraception (EC) at a pharmacy without a prescription from a clinic or doctor.

Teens clearly need more information about responsible decision-making and effective contraception. In 2006, the teen birthrate began to rise after a 14-year period of continuous decline.

For PAP, the information gleaned from the focus group was apparent. Pharmacies are a useful access point to meet teen reproductive health needs. With their convenient locations and long hours, they are often more accessible to teens than community clinics and doctors’ offices.

To help pharmacists get the word out about EC and other reproductive health issues – and tailor their approach to teens’ needs – PAP debuted the Youth-Friendly Pharmacy Initiative (YFPI), the first program of its kind in California, and in fact, the United States. It is funded in part by a three-year, $300,000 core operating support grant from TCWF in June 2007.

Pharmacies have been shown to be useful access points to meet teen reproductive health needs, according to Pharmacy Access Partnership, which lauched its Youth-Friendly Pharmacy Initiative trainings in May 2009. The Client Confidentiality Card has been an effective tool for teens to ask for emergency contraceptives in a discreet way.

“There is good reason to believe that sexually active teens would benefit from wider availability of emergency contraception, given that the majority of teens have sex by the time they graduate high school,” said Julio Marcial, TCWF program director.

This year, the U.S. Food and Drug Administration broadened over-the-counter access of Plan B and its generic version to consumers 17 and older. In California and nine other states, girls 16 and younger and women of any age may get Plan B and the generic directly from specially trained pharmacists without first obtaining a prescription from a doctor or clinic. Plan B is a hormonal contraceptive that prevents pregnancy up to five days after unprotected sex.

Last spring the initiative sponsored hour-long pharmacist trainings in the Bay Area – they’ll be held in the Central Valley, San Diego and San Francisco this fall and be made available online – that covered subjects including minors’ rights and confidentiality; the Family Pact insurance program, which minors can obtain on their own at health clinics; and using social media like Facebook and MySpace to communicate with youth.

The focus groups also showed that privacy is a big issue for teens, who often feel embarrassed to ask for EC within earshot of other customers. That’s why PAP developed the two-part Client Confidentiality Card. The teenage girl tears off the portion containing the question “Got Plan B?” and hands it to the pharmacist. The other half of the card has facts about EC.

These popular cards have been translated into Spanish and Chinese. During the 2008-09 grant year, more than 6,000 were distributed to youth-serving organizations, enabling teens to spread the word to their friends to raise awareness about EC.

“We’ve seen the C-Card become an important educational tool in terms of bridging the gap between youth access and pharmacy provision of contraceptive services,” said Belle Taylor-McGhee, PIWH president and CEO. “It opened up a new conversation and served as an opportunity to expand our reach.”