An important public health priority that can be addressed through MTM services is preconception care, the recognition and management of biomedical or behavioral issues that must occur before or very early in pregnancy to reduce risks to the health of a woman or her baby. Although it is recommended that all women of childbearing potential receive preconception care, current literature suggests that most patients are not routinely receiving the necessary education, counseling, or interventions. This project will examine the impact of pharmacists in providing 3 elements of preconception care to women of childbearing potential through the MTM framework as a targeted medication review: 1. providing drug therapy education to patients receiving category D or X medications and providing recommendations to prescribers for drug therapy modifications as appropriate, 2. educating patients about daily folic acid intake and recommending an appropriate product, and 3. counseling patients on hepatitis B vaccination and providing vaccination or contacting prescribers with requests for vaccination as appropriate. The results of the project will be disseminated via peer-reviewed literature with the intent of convincing payors to expand such services through existing business avenues in MTM payment. Also, as part of the project, an online ACPE-accredited continuing education program about preconception care will be developed for pharmacists and pharmacy technicians. This program will be available for any pharmacist or technician to complete at no additional cost during the duration of the accreditation period.
Certain prescription medications should be avoided during pregnancy to reduce the risk of fetal harm. Identification of these medications to minimize exposure may be achieved through the integration of preconception care recommendations into medication therapy management (MTM) services. The primary objective of this study was to identify missed opportunities for pharmacists to provide preconception care support related to medications associated with adverse pregnancy outcomes for reproductive-aged women who received MTM consultations at a regional supermarket pharmacy chain. Results: Of the 2020 female patients who received MTM services and filled at least 1 prescription during the study period, 731 (36.2%) were found to have received at least 1 medication associated with adverse pregnancy outcomes for the minimal days’ threshold. Of these, 509 (69.6%) lacked evidence of concurrent prescription contraception, and 74 (10.1%) had a concurrent prescription for folic acid or prenatal vitamins. In conclusion, the use of medications associated with adverse pregnancy outcomes was widespread in this sample of reproductive-aged women.
Article featuring research findings and comments from Natalie DiPietro Mager, PharmD, MPH, associate profes- sor of pharmacy practice at Ohio Northern University’s Raabe College of Pharmacy and David Bright, PharmD, associate professor at Ferris State University Col- lege of Pharmacy in Michigan.
There are multiple opportunities for community pharmacists to take on greater roles in the delivery of preconception care and contraceptive services, and pharmacists have indicated interest in developing and expanding such services. Therefore, the objective of this review is to summarize published literature related to community pharmacists' provision of preconception care and contraceptive interventions to help guide related service development and raise awareness about potential opportunities to further expand and integrate such services into practice. The results highlighted the logistical ease, economic viability, and patient acceptance of such services. Opportunities to expand and integrate these services exist. Published data show that community pharmacists have demonstrated provision of contraceptive and preconception care services in the US, and opportunities exist to grow these programs.