New Jersey Administrative Code › Title 13 - LAW AND PUBLIC SAFETY › Chapter 39 - STATE BOARD OF PHARMACY › Subchapter 14 - SELF-ADMINISTERED HORMONAL CONTRACEPTIVES › Section 13:39-14.5 - Procedures for patient counseling and furnishing hormonal contraceptives

Current through Register Vol. 56, No. 14, July 15, 2024
(a) If the pharmacist concludes, based on N.J.A.C. 13:39-14.4, that a self-administered hormonal contraceptive is indicated for the patient, the pharmacist may furnish one. The pharmacist shall:
1. Ensure that the patient is appropriately instructed in the administration of the self-administered hormonal contraceptive.
2. Provide the patient with counseling that includes the following information:
i. An information sheet for the product furnished that includes when and how to take or use the hormonal contraceptive, when the contraceptive becomes effective, what to do if the patient misses a dose or the contraceptive patch or ring dislodges, possible side effects (including the risks, if any, of long-term use), and when to seek medical attention;
ii. The package insert for the product furnished;
iii. The importance of receiving recommended preventative health screenings and following up with the patient's primary care provider or a medical clinic;
iv. That the self-administered hormonal contraceptive does not protect against sexually transmitted infections or HIV, and that the use of a condom does provide protection against sexually transmitted infections and HIV; and
v. Any other information relevant to the hormonal contraceptive furnished; if medroxyprogesterone acetate is furnished, counsel the patient that using it for more than two years is not recommended because of a risk of loss of significant bone mineral density.
3. Provide the patient with a written record of the self-administered hormonal contraceptive furnished. The pharmacist may use the Pharmacist Visit Summary and Referral template set forth at N.J.A.C. 13:39-14 Appendix D and available at
http://www.njconsumeraffairs.gov/phar/Pages/default.aspx
to provide the written record and may customize the template by adding to it, but may not remove any elements from the template. At a minimum, the written record provided by the pharmacist to the patient must include:
i. The patient's name and date of birth;
ii. The name, address, permit number, and telephone number of the pharmacy practice site, and the name, license number, and signature of the pharmacist;
iii. The date of the visit and the date on which the self-administered hormonal contraceptive was furnished;
iv. The name and strength (if applicable) of the contraceptive that was furnished;
v. The quantity furnished and how many refills were authorized (if any);
vi. Any recommended follow-up; and
vii. A statement that information on reproductive rights, health care coverage and services, and other resources can be found at the New Jersey Reproductive Health Information Hub,
http://www.nj.gov/health/reproductivehealth/
.
4. Offer to provide counseling to the patient about other forms of contraception, including contraception not included at N.J.A.C. 13:39-14.3(a), that have been approved by the Federal Food and Drug Administration, and, if the patient accepts the offer for counseling, the pharmacist must provide the patient with specific and appropriate information about such other forms of contraception, based on the results of the Health Screening Questionnaire.
5. At each patient encounter, provide the patient with a referral to the patient's primary care provider, or, if the patient does not have a primary care provider, to an appropriate and nearby medical clinic that provides primary and contraceptive care. The Pharmacist Visit Summary and Referral template set forth at N.J.A.C. 13:39-14 Appendix D and available at
http://www.njconsumeraffairs.gov/phar/Pages/default.aspx
may be used. A pharmacist may customize the template by adding to it, but may not remove any elements from the template.