Pharmacists can effectively dispense mifepristone for abortions

Current FDA requirements mandate that mifepristone, a drug used for medication abortions, be dispensed by certified healthcare providers in clinics, medical offices, or hospitals. Such requirements may be a barrier to accessing medication abortion. One survey found that removing such restrictions may double the number of providers of medication abortion in the US.

In a new ANSIRH study, eligible patients were prescribed mifepristone and misoprostol by a clinician and received the medications from trained pharmacists at a nearby pharmacy. Patients took the medications at home and had standard follow-up with the clinic.

Over 90% of patients in this study indicated their support for pharmacists dispensing of mifepristone. The vast majority reported that they were satisfied with this model of care and that they had received adequate information, either from the clinician or pharmacist. Among participants with follow-up data, 93% had a complete abortion, and none had an ongoing pregnancy. These outcomes are similar to those where the medications are dispensed by a clinician.

Patients had no adverse events related to pharmacist dispensing. And only 1.5% of patients had adverse events possibly related to the abortion. One-third of participants who had had a prior medication abortion reported that the experience of getting the medications at the pharmacy was better than getting mifepristone at a clinic.

There is potential for improvement, with some patients citing pharmacy wait times and confusion on the part of pharmacists as reasons for being less than very satisfied with the pharmacy experience. Another possible concern for widespread implementation is refusal on the part of individual pharmacists or pharmacies to dispense or stock the medication, which could limit the feasibility of the model.

This research demonstrates that pharmacists can safely and effectively dispense mifepristone for medication abortion, and most patients are satisfied with this model of care. It also shows that medication abortion may be offered with a high level of effectiveness and patient satisfaction, and low prevalence of adverse events, without requiring mifepristone to be dispensed in the clinic or medical office.

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