Abstract
Preconception health refers to health before pregnancy and involves addressing risk factors that can negatively impact either a patient or future pregnancy. Pharmacists can play an essential role in screening for and managing patients’ risk factors to optimize pregnancy outcomes. The primary objective of this study is to determine whether preconception health screenings in community pharmacy settings identify opportunities for preconception health services, particularly pharmacy-based interventions. The secondary objectives are to describe the preconception health status of community pharmacy patients and their interest in receiving preconception care services by a clinical pharmacist in a community pharmacy setting. Two independent pharmacies conducted a pilot project where people were invited to complete a health screening form that evaluated their preconception health. Participants received a personalized health report with an invitation to meet with the clinical pharmacist for services related to identified opportunities, such as contraception and immunizations. Retrospective analysis was conducted for data collected from 43 women during the patient screening effort in three community pharmacy settings (two independent community pharmacy locations and one neighborhood pharmacy outreach event). Nearly all participants (n = 42, 98%) had at least one opportunity identified to receive preconception care services, with the majority related to their alcohol use (60%). A majority of participants (56%) indicated an interest in learning more about preconception services offered at the pharmacy, but only 19% wanted to schedule an appointment with a pharmacist. Thus, there is an apparent need and opportunity for utilization of preconception health services at the pharmacy.
Highlights
Preconception care can be defined as individualized care for people that is focused on reducing maternal and fetal morbidity and mortality, increasing the chances of conception when pregnancy is desired, and providing contraceptive counseling to help prevent unintended pregnancies [1].While planning for a pregnancy, the United States Centers for Disease Control and Prevention (CDC) recommends talking to a health care provider about medical conditions, lifestyle, behaviors, medications, and vaccinations—before becoming pregnant [2]
This study aims to further determine if these findings are reproducible in a different geographical setting, expand the patient risk factors assessed, and understand barriers to the utilization of preconception care services in a community pharmacy setting
The primary objective of this study is to determine if screening people of reproductive age in community pharmacy settings identifies opportunities for preconception care services, defined by lack of contraception use, or the presence of one or more risk factors identified in the CDC report on Improving Preconception Health and Health Care [35]
Summary
While planning for a pregnancy, the United States Centers for Disease Control and Prevention (CDC) recommends talking to a health care provider about medical conditions, lifestyle, behaviors, medications, and vaccinations—before becoming pregnant [2]. Recommend that any patient encounter with nonpregnant women or men with reproductive potential is an opportunity to counsel about wellness and healthy habits, which may improve reproductive and obstetric outcomes should they choose to reproduce [3]. This is especially important since nearly half (45%) of all pregnancies in the United States were unintended in 2011 [4]. Lack of adequate preconception care may be further compounded in certain subpopulations, where additional disparities in unintended pregnancy rates exist, such as individuals who are between ages 18 and 24, financially unstable, or cohabiting with rates two to three times that of the national rate [4]
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