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在安大略省,社区药房为药物堕胎分发的mifepristone在当地获取的变化:基于人口的重复横截面研究
Laura Schummers1, Michael R Law2, Kimberlyn McGrail2
1Collaboration for Outcomes Research and Evaluation (Schummers), Faculty of Pharmaceutical Sciences, University of British Columbia; Centre for Health Services and Policy Research (Law, McGrail), School of Population and Public Health, University of British Columbia, Vancouver, BC; Department of Obstetrics and Gynecology (Darling), McMaster University; ICES McMaster (Darling, Gayowsky), Hamilton, Ont.; Department of Obstetrics & Gynaecology (Zusman), Faculty of Medicine, University of British Columbia, Vancouver, BC; Department of Family and Community Medicine (Dunn), University of Toronto; Women's College Research Institute (Dunn), Women's College Hospital, Toronto, Ont.; Department of Family and Emergency Medicine (Kaczorowski), Université de Montréal, Montréal, Que.; ICES UofT (Gozdyra), Toronto, Ont.; Dalla Lana School of Public Health (Gozdyra), University of Toronto, Toronto, Ont.; Department of Family Practice (Norman), Faculty of Medicine, University of British Columbia, Vancouver, BC; Department of Public Health, Environments and Society (Norman), Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK. laura.schummers@ubc.ca.
社区药房可用的mifepristone显著改善了整个安大略省的药物流产机会. 在五年内,区域对米费普里斯顿和堕胎服务的获取大幅扩大,证明了成功的监管方法.
科学领域:
- 生殖健康 生殖健康
- 药品接入 药品接入 药品接入
- 医疗保健政策 医疗保健政策
背景情况:
- 自2017年以来,在加拿大用于药物流产的米费普里斯顿的可用性迅速得到普及.
- 这一监管变化对区域堕胎服务分配的影响尚不清楚.
研究的目的:
- 检查社区药房分发mifepristone如何影响加拿大安大略省堕胎服务的分布.
- 评估mifepristone的可用性对区域获取药物和手术堕胎服务的影响.
主要方法:
- 利用加拿大安大略省2017-2022年链接的卫生行政数据.
- 通过mifepristone分发和相关的计费,诊断和程序代码识别了药物和手术性堕胎.
- 评估了社区药房分发率的变化以及按邮政编码转发分类区域的堕胎服务的地理分布.
主要成果:
- 社区药房分发的米费普里斯从2017年的2%增加到2022年的20%.
- 地区对分发米费普里斯顿的药房的访问率从19%上升到77%,手术性堕胎服务从18%上升到几乎普遍覆盖.
- 堕胎服务用户在当地获得米费普里斯顿或程序服务的比例从37%增加到91%.
结论:
- 在安大略省获得药物堕胎的广泛机会是在米费普里斯顿作为常规处方药的五年内实现的.
- 允许Mifepristone被处方和分发的监管策略通常在扩大当地堕胎服务的可访问性方面显得有效.
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