Pharmacist prescribed hormonal contraceptives in New York State: Is there a need and an interest?

BACKGROUND: Hormonal contraceptives are a popular option for pregnancy prevention and other indications and require a prescription. Since 2013, 24 states have given pharmacists legal authority to initiate self-administered hormonal contraceptives, allowing for direct pharmacy access (DPA). New York State (NYS) did not allow for DPA of any hormonal contraceptives during the survey period, but passed a bill in 2023 allowing pharmacists to dispense hormonal contraceptives in accordance with a nonpatient-specific order. OBJECTIVES: This study aimed to characterize the experiences, perceptions, and knowledge of access to and DPA to hormonal contraceptives. METHODS: A survey was developed to gather responses to demographic- and opinion-related questions and administered online using the Pollfish survey platform. Participants were women between the ages of 16 and 44 years who lived in NYS. To ensure geographic representation, at least one response was gathered from each of the 27 NYS congressional districts. Chi-square tests were used to assess differences in hormonal contraceptive use by patient demographics. RESULTS: Most of the 500 respondents reported past (76.2%) or current/planned (76.8%) use of hormonal contraceptives. Older age (P = 0.033) and higher income (P = 0.0016) were associated with significantly greater rates of use. The most common challenges when visiting a provider for birth control included needing to schedule an appointment and wait times at the provider. Almost three-quarters of respondents (72.6%) were not aware that pharmacists could initiate contraceptives in other states, and 74.2% reported feeling comfortable with a pharmacist prescribing and dispensing hormonal contraceptives. CONCLUSION: Contraceptive initiation by pharmacists would be acceptable to most respondents, but there is room for increased acceptance based on patient education and experience. DPA to hormonal contraceptives may eliminate some of the barriers identified in this survey.

Synthesis and Antiproliferative Evaluation of 2-Deoxy-N-glycosylbenzotriazoles/imidazoles.

A series of 2-deoxy-2-iodo-α-d-mannopyranosylbenzotriazoles was synthesized using the benzyl, 4,6-benzylidene and acetyl protected D-glucal in the presence of N-iodosuccinimide (NIS). Subsequent removal of the iodine at the C-2 position using tributyltin hydride under free radical conditions afforded the 2-deoxy-α-d-glucopyranosylbenzotriazoles in moderate to high yields. This method was extended to the preparation of substituted 2-deoxy-ß-d-glucopyranosylimidazoles as well. The stereoselectivity of the addition reaction and the effect of the protecting group and temperature on anomer distribution of the benzotriazole series were also investigated. The anticancer properties of the newly synthesized compounds were evaluated in a series of viability studies using HeLa (human cervical adenocarcinoma), human breast and lung cancer cell lines. The N-[3,4,6-tri-O-benzyl-2-deoxy-α-d-glucopyranosyl]-1H-benzotriazole and the N-[3,4,6-tri-O-acetyl-2-deoxy-α-d-glucopyranosyl]-2H-benzotriazole were found to be the most potent cancer cell inhibitors at 20 µM concentrations across all four cell lines.