Pharmacy and Wellness Review


Within the current health care system, preconception care is often a misunderstood topic and, in many cases, a missed opportunity to improve women's health and decrease adverse pregnancy outcomes. It is important that preconception care is delivered to all women of childbearing age, regardless of pregnancy intentions, as the interventions associated with preconception care can help improve a woman's health overall. In 2006, the Centers for Disease Control and Prevention (CDC) released four goals, 10 recommendations, and 14 evidence-based interventions regarding preconception care. Pharmacists can have a significant role in ensuring preconception care for all women through the application of the 14 evidence-based interventions which can be viewed in terms of three broad categories: direct provision of care, education and referrals. Diabetes management, hepatitis B and rubella vaccination administration, and oral anticoagulant, antiepileptic, and isotretinoin drug therapy modifications are interventions that can be applied by pharmacists through direct provision of care. Pharmacists can also educate women on folic acid supplementation, obesity control, alcohol intake and smoking cessation. Referrals are recommended for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/ AIDS) and sexually transmitted infection (STI) screening and for the management of maternal phenylketonuria and hypothyroidism. The pharmacist's role in preconception care also expands beyond the 14 evidence-based interventions, as pharmacists can play an important role in helping women and men develop reproductive life plans. Providing preconception care to all women of childbearing age represents an opportunity to encourage healthy behaviors and lifestyle changes that could improve population-based outcomes, while preparing individual patients for a potential pregnancy.



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