Pharmacists could bridge a health care gap by offering more sexual health services

Pharmacists could reduce barriers for people seeking sexual and reproductive health-care services, new University of Alberta research shows.

Many pharmacists already offer some support for sexual and reproductive health, including administering contraceptives and human papillomavirus (HPV) vaccinations. But further training and expansion of these services could help increase access and reduce inequities in this key area of health care.

In the study, U of A researchers surveyed pharmacists working in community pharmacies across Alberta to determine which sexual and reproductive health services they were already providing, and the areas in which they wanted to expand their training. They found that most participants were confident in educating patients in many sexual and reproductive health topics, but that many wanted additional training in sexually transmitted and blood-borne infections as well as health concerns for people in the LGBTQ+ community.

Many people face barriers to accessing necessary sexual and reproductive health services, including limited clinic hours, lack of a primary care physician and confusion about where to address concerns such as testing for sexually transmitted infections. With more training and a co-ordinated effort across the country, pharmacists could become a critical resource to help increase access to these services.

"Pharmacies are one of the most accessible entry points for people to get into the system," says Javiera Navarrete, a research assistant in the Faculty of Pharmacy and Pharmaceutical Sciences. "COVID has highlighted how important it is to use all the health-care resources we have."

Canadian pharmacists are well positioned to expand their scope of practice to include more sexual and reproductive health services. Their training has changed considerably over the last several years, Christine Hughes explains, and a doctor of pharmacy degree has now become the entry-to-practice degree in Canada. Plus, provinces such as Alberta have a compensation framework that allows pharmacists to be paid for services beyond just dispensing, which would help counteract the added workload, she adds.

"There's a lot more focus on patient assessment and clinical interactions with patients, as opposed to historically where it was more dominantly drug dispensing," says Hughes, professor and interim dean in the Faculty of Pharmacy and Pharmaceutical Sciences.

Most Alberta pharmacies have private counselling rooms, which provide the pharmacist and patient with a space and more privacy to discuss sensitive topics. Since many patients can find sexual and reproductive health topics challenging to discuss at the public counter, these rooms are an ideal space for more private discussions, explains Navarrete.

Pharmacists would need more training and professional education before pharmacies can become a go-to community touchpoint for sexual and reproductive health, says Navarrete, and patients would also need education. People who could benefit from these services need to be made aware of their options and the services they could access through pharmacists.

Hughes and Navarrete are collaborating with researchers in Japan and Thailand to get a more comprehensive view of what pharmacists around the world are providing in terms of sexual and reproductive health services. One of the World Health Organization's Sustainable Development Goals is to ensure universal access to sexual and reproductive health services by 2030, yet there's currently no co-ordinated effort worldwide. Research identifying the current state of pharmacy practice could be a key step toward creating a more unified strategy.

"All countries are in different stages of this process, so showing that with data and providing the pharmacists' perspectives is a powerful tool that can allow countries to implement the best models according to their regulations," says Navarrete.

"It's definitely an area for future growth," adds Hughes.