CANADA – Pharmacist checklist and resource guide for medical abortion: User-centred development

by Nevena Rebic, Sarah Munro, Wendy V Norman, Judith A Soon.

Canadian Pharmacists Journal / Revue des Pharmaciens du Canada 2021;154(3):166-74.

Knowledge Into Practice
• Community pharmacists in Canada are able to dispense mifepristone/misoprostol for medical abortion when prescribed by a health professional, such as a physician or nurse practitioner.

• Our study demonstrates the usability and acceptability of the newly developed Pharmacist Checklist for Medical Abortion and the Pharmacist Resource Guide for Medical Abortion created by and for pharmacists.

• The Pharmacist Checklist for Medical Abortion and the Pharmacist Resource Guide for Medical Abortion have the potential to enhance the timely provision of systematic pharmacist counselling for medical abortion, ensuring patients consistently receive high-quality guidance and support for managing their medical abortion health care needs.

In Canada, abortion is a safe, common and legal reproductive health procedure. One in 3 Canadian individuals who become pregnant will experience at least 1 abortion during their reproductive years. Nevertheless, access to abortion services has not been equitable nationwide. In 2012, approximately 300 physicians in Canada provided abortion services, predominately surgical abortions (96%), at 94 facilities primarily located in major cities and urban centres. Patients living outside of urban centres may experience onerous barriers to timely abortion access related to travel, financial disparities and significant wait times. In January 2017, mifepristone 200 mg/misoprostol 800 mcg (Mifegymiso) for medical abortion became available in Canada, offering an opportunity to address inequities in accessing abortion care. Internationally, provider training, reduced financial burdens and expanded eligible prescribers (e.g., family physicians, nurse practitioners, etc.) have enhanced the successful implementation and uptake of this innovation. When Health Canada eliminated several restrictions to mifepristone/misoprostol provision, including physician-only dispensing and mandatory prescriber training in November 2017, pharmacists became an integral part of abortion provision. Nevertheless, uptake of mifepristone prescribing across the country continued to be variable and pharmacists experienced barriers to providing care to their patients.

We recognized that novel educational and dispensing resources were needed to support the expanded role of Canadian pharmacists in medical abortion care. We aimed to develop an effective and efficient Pharmacist Checklist and Resource Guide to promote consistent dispensing of mifepristone and facilitate widespread adoption of medical abortion services in community pharmacy practice.


Rebic N, Gilbert K, Soon JA. “Now what?!” A practice tool for pharmacist-driven options counselling for unintended pregnancy. Canadian Pharmacists Journal / Revue des Pharmaciens du Canada 2021;154(4):248-55.

Munro S, Wahl K, Soon JA, Guilbert E, Wilcox ES, Leduc-Robert G, et al. Pharmacist dispensing of the abortion pill in Canada: Diffusion of Innovation meets integrated knowledge translation. Implementation Science 2021;16(1):76.