An Observational Study of Nicotine Replacement Therapy Availability Through Pharmacist Prescribing in the California Central Valley.

BACKGROUND

California's Central Valley has high rates of tobacco product use and low rates of access to healthcare providers, making it difficult for residents to acquire effective tobacco cessation treatment. To address this disparity, California pharmacists can act as healthcare providers, with the ability to provide counseling and independently prescribe nicotine replacement therapy (NRT) medications through a process known as "furnishing".

METHODS

All corporate and independent pharmacies in the Central Valley who serve the general community were contacted (n = 586) to ask whether pharmacists furnished NRT. The authors visited pharmacy locations (n = 23) that indicated they furnished NRT to request participation in a survey and interview. The authors analyzed if pharmacies furnished NRT, the characteristics of those that furnished, the creation of implementation of protocols, barriers, and facilitators, and how services were fostered.

RESULTS

In interviews, pharmacists expressed generally positive attitudes toward furnishing, but were concerned about barriers, including concerns about feasibility and affordability, lack of administrative support, and perceived limited demand.

CONCLUSIONS

Despite the region's high tobacco usage rates, few pharmacies (n = 5; 0.88%) furnished NRT. To increase furnishing rates, corporate policy changes, recognition of pharmacists as providers by insurance companies, and support from the California Board of Pharmacy are likely needed. Increasing advertising, building rapport, and knowing patients' tobacco history may increase NRT utilization.