Q&A: Pharmacists Help Close Gaps in Abortion Medication Access

Pharmacists are vital in medication abortion care, offering counseling, dosing guidance, and clinical oversight. They also support evidence-based practices through education and advocacy. However, varying state laws and legal restrictions pose major challenges. Staying informed and trained is essential for pharmacists to effectively support safe, accessible abortion care in their communities.

Q&A: Pharmacists Help Close Gaps in Abortion Medication Access / Kadmy - stock.adobe.com

Drug Topics recently sat down with Nicole Cieri-Hutcherson, PharmD, BCPS, MSCP, FCCP, clinical associate professor at University at Buffalo, to discuss what ways pharmacists can support patient counseling and education around medication abortion, what types of training or continuing education could better prepare pharmacists to safely dispense medication abortion, and the most significant challenges pharmacists might face in implementing medication abortion services.

Drug Topics: How can pharmacists support patient counseling and education around medication abortion?

Nicole Cieri-Hutcherson, PharmD, BCPS, MSCP, FCCP: There's a lot of steps in the process that pharmacists can provide patient with information about. Pharmacists not only in community pharmacy settings where this is allowed can provide this education, but also in other settings, such as a hospital or an emergency department. As a highly trained health care professional, a pharmacist can not only dispense the medication, but talk the patient through how the therapeutic indication works, how the medication works, interactions, side effects to expect, what to expect with bleeding and those very rare other side effects that might occur that are part of the medication guide.

In hospital or emergency departments, the pharmacist can serve as a safety checkpoint for any mifepristone and misoprostol orders, making sure that the indication is appropriate, that the dose is appropriate, being involved in the REMS program and monitoring for safety. In addition, pharmacists can really work within a health care system to be an advocate for evidence based medication care and evidence based medication abortion care. They can provide their expertise in terms of protocol development, guideline development and advocacy work in ensuring access to medication abortion.

Drug Topics: What types of training or continuing education could better prepare pharmacists to safely dispense medication abortion?

Cieri-Hutcherson: There's a lot of different trainings that are available. I'd say that most of them are through private organizations, but sometimes it's as simple as just taking an updated continuing education program on medication abortion care. A couple that I've taken myself that I think were well done include Birth Control Pharmacist, they have some great resources and in their community, on their website, as well as ACOG and the National Abortion Federation. Then there's a couple other private groups out there that provide education about how to counsel a patient on medication abortion, what to expect, variations in state laws. One of the things that I will say is that if you're looking to provide this type of care, make sure that you're aware of the laws within your state and federally, the things that govern your ability to dispense and provide this type of care for patients.

Drug Topics: what are the most significant challenges pharmacists might face in implementing medication abortion services, and how can these be addressed?

Cieri-Hutcherson: The most significant challenges that pharmacists face are related to the ever evolving legislation involving medication abortion care. There are state laws that ban or restrict abortion and medication abortion, and they don't just apply to abortion procedures. It can apply to the medication abortion as well. There are large sections of the country that ban abortion, and even though federally, the FDA has approved mifepristone and said that it's safe and effective following the Dobbs decision, and even prior to the Dobbs decision, there are restrictions on providing medication abortion in different states, and who can provide that in a state.

There are other ways that states can restrict access to medication abortion, and sometimes that involves blocking the use of telehealth abortions or mandating inpatient in person patient visits. Sometimes it involves pharmacists, especially if they're dispensing or counseling on medication abortion. As part of the steps that have been taken to limit abortion access, some states have taken action against pharmacists providing medication abortion. As I said before, it's really important to know what your state laws are, what's currently banned, and what legislation is in progress, so that you can get involved in that and continue to provide evidence based medication abortion care for your patients.

READ MORE: Pharmacists Play Key Role in Expanding Access to Medication Abortion

Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our free Drug Topics newsletter.