Dataset Information

Patient Screenings for Preconception Health Interventions at a Community Pharmacy.

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.

SUBMITTER: Luli AJ

PROVIDER: S-EPMC7712468 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Patient Screenings for Preconception Health Interventions at a Community Pharmacy.

Luli Alex J AJ Tran Natalie N Ataya Angela A Rafie Sally S

Pharmacy (Basel, Switzerland) 20201005 4

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 interventi ...[more]

PMID: 33027982

Similar Datasets

Project description:BackgroundCommunity pharmacists can deliver health care advice at an opportunistic level, related to prescription or non-prescription medicines and as part of focused services designed to reduce specific risks to health. Obesity, smoking and excessive alcohol intake are three of the most significant modifiable risk factors for morbidity and mortality in the UK, and interventions led by community pharmacists, aimed at these three risk factors, have been identified by the government as public health priorities. In 2008, the Department of Health for England stated that 'a sound evidence base that demonstrates how pharmacy delivers effective, high quality and value for money services is needed'; this systematic review aims to respond to this requirement.Methods/designWe will search the databases MEDLINE, Embase, CINAHL, PsycINFO, Social Sciences Citation Index, ASSIA, IBSS, Sociological Abstracts, Scopus and NHS Economic Evaluation Database for studies that have evaluated interventions based on community pharmacies that aim to target weight management, smoking cessation and alcohol misuse. We will include all randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before-after studies (CBAs) and interrupted time series (ITS) and repeated measures studies. Data from included studies will be extracted by two independent reviewers and will include study details methods, results, intervention implementation/costs and methodological quality. Meta-analysis will be conducted if appropriate; if not, the synthesis will be restricted to a narrative overview of individual studies looking at the same question.DiscussionThe review aims to summarise the evidence base on the effectiveness of community pharmacy interventions on health and health behaviours in relation to weight management, smoking cessation and alcohol misuse. It will also explore if, and how, socio-economic status, gender, ethnicity and age moderate the effect of the interventions and will describe how the interventions included in the review have been organised, implemented and delivered, since context is an important factor governing the success of public health interventions. The findings from this review will have an impact on the commissioning of public health services aiming to promote healthy weight, smoking cessation and prevent excessive alcohol consumption.Systematic review registrationThe review has been registered with PROSPERO (registration no. CRD42013005943). Available at: http://www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42013005943.

Project description:To systematically review the effectiveness of community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management.Systematic review and meta-analyses. 10 electronic databases were searched from inception to May 2014.randomised and non-randomised controlled trials; controlled before/after studies, interrupted times series.any relevant intervention set in a community pharmacy, delivered by the pharmacy team. No restrictions on duration, country, age, or language.19 studies were included: 2 alcohol reduction, 12 smoking cessation and 5 weight management. Study quality rating: 6 'strong', 4 'moderate' and 9 'weak'. 8 studies were conducted in the UK, 4 in the USA, 2 in Australia, 1 each in 5 other countries. Evidence from 2 alcohol-reduction interventions was limited. Behavioural support and/or nicotine replacement therapy are effective and cost-effective for smoking cessation: pooled OR was 2.56 (95% CI 1.45 to 4.53) for active intervention vs usual care. Pharmacy-based interventions produced similar weight loss compared with active interventions in other primary care settings; however, weight loss was not sustained longer term in a range of primary care and commercial settings compared with control. Pharmacy-based weight management interventions have similar provider costs to those delivered in other primary care settings, which are greater than those delivered by commercial organisations. Very few studies explored if and how sociodemographic or socioeconomic variables moderated intervention effects. Insufficient information was available to examine relationships between effectiveness and behaviour change strategies, implementation factors, or organisation and delivery of interventions.Community pharmacy-delivered interventions are effective for smoking cessation, and demonstrate that the pharmacy is a feasible option for weight management interventions. Given the potential reach, effectiveness and associated costs of these interventions, commissioners should consider using community pharmacies to help deliver public health services.

Project description:IntroductionThere is increasingly a double burden of under-nutrition and obesity in women of reproductive age. Preconception underweight or overweight, short stature and micronutrient deficiencies all contribute to excess maternal and fetal complications during pregnancy.MethodsA systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on maternal, newborn and child health (MNCH) outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture.ResultsMaternal pre-pregnancy weight is a significant factor in the preconception period with underweight contributing to a 32% higher risk of preterm birth, and obesity more than doubling the risk for preeclampsia, gestational diabetes. Overweight women are more likely to undergo a Cesarean delivery, and their newborns have higher chances of being born with a neural tube or congenital heart defect. Among nutrition-specific interventions, preconception folic acid supplementation has the strongest evidence of effect, preventing 69% of recurrent neural tube defects. Multiple micronutrient supplementation shows promise to reduce the rates of congenital anomalies and risk of preeclampsia. Although over 40% of women worldwide are anemic in the preconception period, only one study has shown a risk for low birth weight.ConclusionAll women, but especially those who become pregnant in adolescence or have closely-spaced pregnancies (inter-pregnancy interval less than six months), require nutritional assessment and appropriate intervention in the preconception period with an emphasis on optimizing maternal body mass index and micronutrient reserves. Increasing coverage of nutrition-specific and nutrition-sensitive strategies (such as food fortification; integration of nutrition initiatives with other maternal and child health interventions; and community based platforms) is necessary among adolescent girls and women of reproductive age. The effectiveness of interventions will need to be simultaneously monitored, and form the basis for the development of improved delivery strategies and new nutritional interventions.

Project description:Objective Few community pharmacies have access to health information exchange (HIE) data. We conducted a first-of-its-kind usability evaluation of an HIE interface prototype (referred to throughout as the "HIE-Pioneer mock-up") developed with pharmacists and pharmacy technicians to aid future implementation in community pharmacies.Methods Community pharmacists and pharmacy technicians were recruited to complete usability evaluations with the HIE-Pioneer mock-up. Each usability evaluation lasted up to 60 minutes. System usability scale (SUS) scores were collected from each participant following each usability evaluation session and summarized with descriptive statistics. Usability evaluation videos were reviewed for common usability attributes, such as the impact of identified usability problems, learnability, and efficiency. Time on task, task success rates, and prototype utilization were also recorded.Results Sixteen total participants completed usability testing across three community pharmacies. The average SUS score was 69.7 (scale 0-100, where 100 is the best), with pharmacists on average reporting higher satisfaction than technicians (74.1 vs. 65.3, respectively). Altogether, we identified 23 distinct usability problems. Key problems identified included needed clarification in tool label names and accessibility of HIE links within the existing workflow. Overall, the usability of the HIE-Pioneer mock-up generally fostered pharmacy professionals' ease of learning and efficiency.Conclusion Our study identified key areas, and potential solutions, to improve the usability of the HIE-Pioneer mock-up. Overall, pharmacy professionals viewed the HIE-Pioneer mock-up positively, with good satisfaction ratings. The HIE-Pioneer mock-up provides a blueprint for future HIE implementation in community pharmacy settings, which would increase community pharmacy teams' access to HIE data nationwide. Community pharmacy access to bi-directional HIE is expected to improve communication among more health care professionals involved in patient care and equip pharmacy professionals with needed information for improved clinical decision-making.

Project description:Insomnia is one of the most common minor ailments to which patients seek advice in a community pharmacy setting. Due to the availability of a wide variety of over-the-counter (OTC) products, community pharmacists are in the front line to safe-guard patients looking for self-medication or advice for treatment of insomnia. The purpose of this study was to assess the content of community pharmacists' interactions with patients seeking advice for insomnia in Jordan. A cross-sectional study using a simulated patient methodology was conducted across a stratified convenience sample of community pharmacies in three major cities in Jordan. The visits were evaluated using pre-defined criteria adapted from published literature relating to content and counseling skills. Visits were audio-recorded using a hidden microphone and the simulated patient completed a data collection form immediately after each visit. A total of 67 community pharmacies (response rate = 93.0%) agreed to participate and were all visited once by the simulated patient. The median duration of the visit was 2 minutes (range: 0.2-4 minutes). The majority (86.6%) of visits resulted in the sale of a drug, most commonly a combination product (paracetamol and diphenhydramine) for 30 recommendations (44.8%). This was followed by a natural plant extract combination product, namely valerian and lemon balm (Melissa officinalis L.) for 23 (34.3%). Pharmacists often did not question medical history or other symptoms prior to product sale. Frequently, the recommended dose (49.3%) and administration time (38.8%) were the only information provided to the patient. No information was provided in relation to potential drug interactions or contraindications. No advice was offered on lifestyle or good sleeping hygiene. This study provided evidence that community pharmacists in Jordan in general did not offer adequate counseling for patients seeking advice for insomnia. Exploration of the reasons and factors contributing to this practice and highlighting professional opportunity and responsibility is recommended.

Dataset Information

Patient Screenings for Preconception Health Interventions at a Community Pharmacy.

Publications

Patient Screenings for Preconception Health Interventions at a Community Pharmacy.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets