Pharmacists: Prescribing Birth Control In New Brunswick

In New Brunswick, pharmacists can prescribe birth control to eligible residents who meet specific criteria. This service is provided at no cost to the patient, although medication costs are not covered. To be eligible, individuals must be New Brunswick residents with a valid NB Medicare card, aged 12 to 50, not pregnant or breastfeeding, and not residing in a nursing home. This initiative aims to improve access to birth control and reduce potential barriers to care.

Eligibility criteria for pharmacist-prescribed birth control in New Brunswick

To be eligible for pharmacist-prescribed birth control in New Brunswick, patients must meet the following criteria:

• Be a resident of New Brunswick and have a valid NB Medicare card
• Be between the ages of 12 and 50
• Have a menstrual cycle and not be experiencing unusual menstrual changes
• Not be pregnant or breastfeeding, or within 6 weeks postpartum
• Not reside in a nursing home or a correctional facility

Eligible patients can receive a maximum of one initial assessment and two follow-up assessment services per year. It is important to note that the program does not cover the cost of dispensing fees, injection fees, or the prescribed medications.

The pharmacist will provide the service in person and will complete a comprehensive assessment, including obtaining the patient's social history, medical history, and blood pressure measurement. They will discuss all appropriate options, including those they cannot prescribe, and refer the patient to another healthcare provider if necessary. If medication is prescribed, the pharmacist will schedule a follow-up assessment to monitor safety and efficacy and will notify the patient's primary care provider. The prescription must be filled on the same day as the assessment.

The role of pharmacists in family planning services

Pharmacists can provide a range of services related to family planning, including pregnancy tests, condoms, emergency contraception, and prescription medications like misoprostol and hormonal contraception. They may also collaborate with other healthcare providers, such as physicians, to offer a broader range of contraceptive methods, including hormonal implants and intra-uterine devices (IUDs or IUCs).

In certain places, pharmacists are authorised to prescribe self-administered hormonal birth control methods, such as pills, patches, rings, and injections. This authority varies by region, with some places having passed laws permitting this practice, while others are considering similar legislation.

Pharmacists can play an active role in family planning by:

• Dispensing family planning products and providing free advice to clients.
• Educating and counselling patients on various family planning methods, their advantages, and appropriate usage.
• Referring patients to physicians or specialists in case of problems or when a patient's needs fall outside the pharmacist's scope of practice.
• Participating in the elaboration of laws and regulations governing the manufacture, storage, pricing, and distribution of contraceptives.
• Cooperating with physicians and other healthcare professionals to provide comprehensive family planning services.

In addition, pharmacists can contribute to improving access to family planning services by:

• Extending their operating hours and days, including weekends, to accommodate patients' schedules.
• Offering services without the need for appointments, reducing wait times, and providing timely access to care.
• Providing a stigma-free environment, which can be particularly important for individuals facing barriers or concerns related to stigma when seeking reproductive healthcare.
• Dispensing a full range of FDA-approved contraceptives, to the extent allowed by state or local laws.
• Dispensing accurate and up-to-date information about reproductive health products and services, including emergency contraception, to help patients make informed decisions.

The process of getting a birth control prescription from a pharmacist

In New Brunswick, pharmacists can assess and prescribe birth control to eligible residents who meet the necessary criteria. This service is provided at no cost to the patient, although the cost of the dispensing fee, injection fee, or prescribed medication is not covered by the program.

To be eligible for this service, patients must be New Brunswick residents with a valid NB Medicare card, be between the ages of 12 and 50, have a menstrual cycle without any unusual changes, not be pregnant or breastfeeding, and not reside in a nursing home.

• Find a Pharmacy: Start by locating a pharmacy that offers birth control prescription services. Most pharmacies in New Brunswick provide these services, but it is always good to check beforehand. You can visit the pharmacy's website or give them a call to confirm.
• Initial Consultation: During your first visit, the pharmacist will explain the process and obtain your consent for the assessment. You may meet with the pharmacist in a private counselling room, and they will discuss your medical history, medications, symptoms, and any relevant details to understand your needs and preferences.
• Assessment and Prescription: The pharmacist will conduct a comprehensive assessment, including obtaining your social and medical history and measuring your blood pressure. Based on the assessment, they will discuss appropriate birth control options, including methods they can and cannot prescribe.
• Collaboration with Healthcare Provider: If you prefer a medication that the pharmacist cannot prescribe, they will refer you to an appropriate healthcare provider or service. In the case of hormonal implants or intra-uterine devices (IUD or IUC), pharmacists typically work in collaboration with a primary care provider who can conduct the necessary physical exam and insert the device.
• Prescription and Follow-up: If the pharmacist prescribes medication, they will prepare the prescription for you to fill on the same day as the assessment. They will also schedule a follow-up assessment to monitor the safety and efficacy of the prescribed birth control.
• Notification to Primary Care Provider: The pharmacist will notify your primary care provider (if you have one) about the prescribed medication. If you do not have a primary care provider, the pharmacist will provide you with a copy of the notification for your records.

It is important to note that the process may vary slightly between different pharmacies and locations, so it is always a good idea to contact the pharmacy or check their website for specific details.

Benefits of pharmacist-prescribed birth control

Convenience and Accessibility

Pharmacists are often more accessible than other healthcare providers, making contraceptive care visits less burdensome, especially for those living in underserved communities, rural areas, and contraceptive deserts. In addition, pharmacies are often located closer to patients' homes, have longer opening hours, and do not require appointments for consultations. This increases the likelihood of longer-term continued and consistent contraceptive use, and reduces the likelihood of unintended pregnancies.

Cost-Effectiveness

Pharmacist-prescribed birth control is more cost-effective and may reduce other healthcare costs. For example, two years after Oregon implemented its pharmacist-prescribed contraception protocol, the policy prevented an estimated 51 unintended pregnancies and saved the state $1.6 million. The cost savings associated with making hormonal birth control accessible in pharmacies have been shown to exceed the costs.

Improved Patient Outcomes

Pharmacist-prescribed birth control improves pregnancy outcomes, increases contraceptive regimen adherence and continuation, and minimizes costs. A 2008 survey in Washington state found that 70% of women reported continued use of their pharmacist-prescribed contraceptive method after 12 months, and almost every respondent expressed willingness to continue to see pharmacist prescribers for contraceptive services.

Reduced Logistical Burdens

Pharmacist prescribing eliminates the need for patients to first get a prescription from a physician, reducing logistical burdens and other barriers such as scheduling appointments, taking time off work, travel time, and childcare. Pharmacist prescribing allows most people to make one stop at the pharmacy for contraceptive care.

Safe and Effective

Pharmacist prescribing of contraceptives has been proven to be safe and effective. Studies show that women can self-screen and non-physicians can safely assess contraindications to using oral contraception. Pharmacists can refer patients who need to use other methods.

Other services offered by pharmacists in New Brunswick

In addition to prescribing birth control, pharmacists in New Brunswick can offer a range of other services to their patients. These services include:

• Assessing and treating minor ailments such as cold sores, uncomplicated urinary tract infections, allergies, and emergency contraception.
• Administering publicly funded vaccines to eligible residents.
• Providing prescription renewals.
• Treating mild acne, cold sores, conjunctivitis, contact allergic dermatitis, mild to moderate eczema, gastroesophageal reflux disease (GERD), impetigo, shingles, and vaginal candidiasis.
• Assessing and prescribing for contraception management.
• Offering point-of-care testing and prescribing for Group A Strep (strep throat).
• Managing chronic diseases such as diabetes, COPD, asthma, and cardiovascular disease.
• Collaborating with health system partners, empowering pharmacy professionals, and supporting the evolving patient care needs of New Brunswickers.
• Working closely with physicians, nurses, and other care team members to help choose the best medications for patients, ensuring medication plans are safe, effective, and appropriate.
• Making recommendations based on patient-specific factors such as kidney function, ability to swallow, and potential drug interactions.
• Educating patients about the medications they are taking and why it is important to adhere to their medication regimens.

Frequently asked questions