Journal of the American Pharmacists Association : JAPhA · 2025
New Mexico community pharmacists' knowledge and perspectives of mifepristone and misoprostol for early pregnancy loss.
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Herman Alexandra, Trujillo Victoria Y, Krashin Jamie W, Gallegos Aragon Kelsea
Аннотация
BACKGROUND: Early pregnancy loss (EPL) is common, affecting approximately 25% of pregnancies. Medication management with mifepristone and misoprostol allows patients to choose a nonprocedural option for management. While pharmacy access to reproductive health care such as contraception has expanded in recent years, access to care for other reproductive health care such as EPL in community pharmacies remains limited due to barriers such as Food and Drug Administration Risk Evaluation and Mitigation Strategies (REMS).
OBJECTIVES: The objective of this study was to explore New Mexico community pharmacists' experiences, knowledge, and perspectives on pharmacy access to mifepristone and misoprostol for the management of EPL in order to elucidate strategies for expanding access to EPL care.
METHODS: This qualitative study utilized semi-structured phone interviews with pharmacists practicing in the community in rural and urban areas of New Mexico. Interviews were transcribed verbatim and underwent thematic analysis by 2 independent coders using Dedoose software (dedoose.com).
RESULTS: The majority of pharmacists had experience and were confident in dispensing misoprostol and expressed willingness to dispense mifepristone if current REMS criteria were removed or amended. Pharmacists rated themselves as knowledgeable about misoprostol, with most reporting no or limited familiarity with mifepristone and current guidelines for treatment of EPL. Pharmacists saw themselves in an important role supporting and providing medication counseling for patients experiencing EPL but reported that barriers such as corporate policies, limited availability of qualified prescribers, including obstetrician-gynecologists, in their communities, and lack of training could limit access to medications for EPL.
CONCLUSION: New Mexico community pharmacists are supportive of pharmacy access to misoprostol and mifepristone for EPL management, and are interested in more training to increase their knowledge and confidence in providing care for patients experiencing EPL. Further research is needed, particularly in other states, to better understand broader implementation challenges.
OBJECTIVES: The objective of this study was to explore New Mexico community pharmacists' experiences, knowledge, and perspectives on pharmacy access to mifepristone and misoprostol for the management of EPL in order to elucidate strategies for expanding access to EPL care.
METHODS: This qualitative study utilized semi-structured phone interviews with pharmacists practicing in the community in rural and urban areas of New Mexico. Interviews were transcribed verbatim and underwent thematic analysis by 2 independent coders using Dedoose software (dedoose.com).
RESULTS: The majority of pharmacists had experience and were confident in dispensing misoprostol and expressed willingness to dispense mifepristone if current REMS criteria were removed or amended. Pharmacists rated themselves as knowledgeable about misoprostol, with most reporting no or limited familiarity with mifepristone and current guidelines for treatment of EPL. Pharmacists saw themselves in an important role supporting and providing medication counseling for patients experiencing EPL but reported that barriers such as corporate policies, limited availability of qualified prescribers, including obstetrician-gynecologists, in their communities, and lack of training could limit access to medications for EPL.
CONCLUSION: New Mexico community pharmacists are supportive of pharmacy access to misoprostol and mifepristone for EPL management, and are interested in more training to increase their knowledge and confidence in providing care for patients experiencing EPL. Further research is needed, particularly in other states, to better understand broader implementation challenges.