Abstract
The objective of this paper is to demonstrate how both individual family physicians and pharmacists, as well as larger primary care organisations can contribute to the implementation of preconception care delivery i.e. to establish the service, to reach the target population and to add sustainably and effectively to the primary goals of preconception care i.e. to modify the risks to the health of future children and more specifically with respect to rare diseases. This paper comprises a short introduction into the contents of preconception care and a structured debate in which implementation options are will be explored such as; seizing opportunities in daily practice, integration in contraception counselling and/or sexual and reproductive health programmes; selection of and outreach to, high risk subgroups defined for example by genetic predisposition, social economic deprivation, chronic diseases etc. The readers are expected to understand options to improve preconception pharmaceutical care applicable in their own healthcare system. Community pharmacists are in a privileged position to implement pharmaceutical care to prevent rare diseases wherever possible by dispensing safe medicines and advising healthy life-style and genetic counselling before conception as well as occasionally referring to the possibility of assisted reproductive technology.
Highlights
A hundred years ago (5 September 1919) the “Nationaal Werk voor Kinderwelzijn/Oeuvre Nationale de l ’ Enfance ” (National Institute for Child Welfare) was established in Belgium to ensure child protection and to disseminate basic rules for betterSafe medicines before pregnancyCommunity pharmacists are in a privileged position to deliver correct pharmaceutical care to couples with a wish to have children, as in many situations the pregnancy test is delivered in a community pharmacy
Mycophenolate mofetil is taken by many patients with rare inflammatory diseases and because of its teratogenic properties [10] it can best be switched before conception to another treatment [13]
Adherence to medication and diet for rare disease patients is very important in this period to keep levels within the required range to avoid congenital defects
Summary
Community pharmacists are in a privileged position to deliver correct pharmaceutical care to couples with a wish to have children, as in many situations the pregnancy test is delivered in a community pharmacy. At this point, important actions need to be taken to optimise the fertility of the women and her partner as well as to protect the health of the future mother and her foetus [3]. Due to the overview of the medication, pharmacists are aware of rare genetic diseases in the families of their patients. Lab on a chip devices with multiple laboratory processes on a single
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