Contraception on Demand program expands access to reproductive care

Women are the fastest growing group in the Veteran population, and are expected to make up 18% of the Veteran population by 2040. VA provides comprehensive contraception care services and offers a wide range of contraceptive options for Veterans, yet one-third of Veteran pregnancies are unintended. Access issues and refill delays further complicate existing gaps in contraceptive coverage.

In 2019, a group of researchers and primary care clinical pharmacists at Pittsburgh VA had an idea to improve Veterans’ access to these vital prescriptions. Enter Contraception on Demand (COD), a patient-centered innovation that enables VA facilities to expand access to contraception for Veterans while reducing costs.

Developing Contraception on Demand

The team tested two strategies for COD. The first was pharmacist-led contraceptive prescribing. The second was dispensing hormonal birth control in 12-month refills instead of one to three-month refills mandated by VA at that time.

Expanding pharmacist-led prescribing and 12-month dispensing increases access to essential reproductive health services, meaningfully expands clinical pharmacy practitioners’ role in reproductive health care, and supports Veterans’ reproductive autonomy. These strategies also have the potential to save time and reduce burden for both Veterans and providers and ultimately to reduce costs for VA.

After a year and a half of designing the project alongside Puget Sound VA, training the clinical pharmacists and bringing in a second VA facility, the team launched a new pilot at both facilities in July 2021. Veterans and VA pharmacists responded with enthusiasm and the COD team decided to enter their innovation in VHA Diffusion of Excellence’s 2022 VHA Shark Tank Competition.

Multiplying the impact of the Contraception on Demand program

COD was selected as a VHA Shark Tank Competition finalist and Dr. Deirdre Quinn, the team’s ACore Investigator, pitched the innovation at the competition. After receiving multiple bids, hers was selected as a winner to replicate to additional sites, including:

• Eastern Colorado VA  
• Miami VA
• Tampa VA
• Orlando VA
• West Palm Beach VA

The team continues working with national VHA program office stakeholders, building valuable relationships and highlighting the power of the innovation to improve Veteran access to care.

“I never realized all you needed was an idea, and the Diffusion Team will help you make it a viable project. You don’t need ten years of research. You just need the spark of an idea,” Dr. Quinn said.

To learn more about COD, explore their page on the Diffusion Marketplace. If you or a Veteran you know are looking to learn more, contact your VA Primary Care provider.

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