Community Pharmacist-Led Interventions to Improve Preconception and Pregnancy Health: A Systematic Review

Background: Community pharmacist-led interventions are effective in improving health outcomes; however, their impact in improving preconception and pregnancy health is not clear. This study evaluated the effectiveness of community pharmacist-led interventions which aimed to improve health outcomes of preconception and pregnant women. Methods: A systematic review of the literature, consistent with PRISMA guidelines, was performed. Five electronic databases were searched up to February 2021. Results: Four studies, three in pregnant women and one in preconception women, were identified. The studies focused on improving micronutrient status and smoking cessation. The studies increased knowledge about, and use of, iron supplements, and improved iron status and smoking cessation rates in pregnant women, while improving knowledge regarding, and increasing the use of, preconception folic acid. The studies were ranked as weak to moderate quality. Conclusion: This review provides preliminary evidence for the potential benefit of community pharmacist-led interventions to improve the health of women before and during pregnancy.

Impact of Interventions by a Community Pharmacist on Care Burden for People with Dementia: Development and Randomised Feasibility Trial of an Intervention Protocol

Background: Traditionally, the role of pharmacists has been to manage and monitor pharmacotherapy for patients with dementia. However, additional intervention by community pharmacists to collect and share patient information with other professionals may help reduce the care burden among caregivers. This study examined the impact of interventions by a community pharmacist, based on active information gathering from other professionals for people with dementia, on the caregivers’ burden of care.Methods: This was a randomised, open-label, parallel-group feasibility study, involving eight Nara City pharmaceutical association member pharmacies that provided consent to participate. These pharmacies were assigned to an intervention group or control group at a 1:1 ratio. The subjects were patients with dementia and their primary caregivers that visited the participating pharmacies and provided consent to participate. Pharmacists in the intervention group actively collected information from the patients’ family physicians and care managers and intervened to address medication-related problems, while those in the control group only performed their normal duties. The primary endpoint was a change in the caregiver’s score on the Japanese version of Zarit Caregiver Burden Interview (J-ZBI) from the baseline to after 5 months of follow-up. The changes in mean J-ZBI scores from the beginning to the end of the study period of the two groups were compared using Welch's t-test, and effect sizes were calculated. The level of significance was set at 5%.Results: Totally, nine patients and nine caregivers in the intervention group, and nine patients and eight caregivers in the control group completed the study. The changes in J-ZBI scores could be calculated for seven cases in the intervention group and five cases in the control group. The J-ZBI scores were found to decrease by 1.0 in the intervention group and increase by 3.0 in the control group (p = 0.075, effect size = 1.414).Conclusions: Although the differences in J-ZBI scores were not statistically significant between the two groups, owing to the small sample sizes, the effect sizes suggest that community pharmacist interventions for people with dementia may reduce the care burden for caregivers.Trial registration: Registration: UMIN000039949 (registration date: 4.1.2020, retrospectively registered)