Community Pharmacist-Led Interventions to Improve Preconception and Pregnancy Health: A Systematic Review.

Polly A Scott,Kathryn V Dalrymple,Ola F Quotah,Sara L White,Shivali Lakhani,Lucilla Poston,Mitch Blair,Angela C Flynn,Marsha Alter,Jessica Farebrother,John Weinman

doi:10.3390/pharmacy9040171

Abstract

Background: Community pharmacist-led interventions are effective in improving health outcomes; however, their impact in improving preconception and pregnancy health is not clear. This study evaluated the effectiveness of community pharmacist-led interventions which aimed to improve health outcomes of preconception and pregnant women. Methods: A systematic review of the literature, consistent with PRISMA guidelines, was performed. Five electronic databases were searched up to February 2021. Results: Four studies, three in pregnant women and one in preconception women, were identified. The studies focused on improving micronutrient status and smoking cessation. The studies increased knowledge about, and use of, iron supplements, and improved iron status and smoking cessation rates in pregnant women, while improving knowledge regarding, and increasing the use of, preconception folic acid. The studies were ranked as weak to moderate quality. Conclusion: This review provides preliminary evidence for the potential benefit of community pharmacist-led interventions to improve the health of women before and during pregnancy.

Highlights

Over the last decade, the prevalence of obesity has increased [1] with significant consequences for maternal, infant and childhood outcomes
Studies meeting the following criteria were excluded: (1) observational or qualitative research; (2) abstracts; (3) women aged less than 18 years or older than 50 years; (4) interventions delivered by pharmacists within a hospital or online; (5) studies not published in English
This systematic review provides some evidence to suggest that community pharmacistled interventions improved adherence to iron supplements, iron status and smoking cessation rates in pregnant women in addition to increasing awareness and use of folic acid supplements in women before pregnancy

Summary

Introduction

The prevalence of obesity has increased [1] with significant consequences for maternal, infant and childhood outcomes. This has stimulated a public health focus to promote healthier lifestyles amongst pregnant women and those contemplating pregnancy [2,3]. It is well recognised that sub-optimal nutrition during pregnancy can increase the risk of micronutrient deficiencies implicated in poor foetal growth and development [4]. Sub-optimal health behaviours and risk factors for adverse pregnancy outcomes are usually established well before conception. Our recent survey, which described health behaviours of over 130,000 UK women planning pregnancy, showed that 20% were smokers, less than one third took folic acid supplements and approximately half were consuming

Methods

Results

Discussion

Conclusion