Use of targeted medication reviews to deliver preconception care: A demonstration project

Abstract

Objectives: To demonstrate the ability of a statewide network of community pharmacists to provide preconception care services with the use of targeted medication reviews (TMRs). Community pharmacists are well qualified and well positioned to assist in this public health priority; however, there are no documented case studies of pharmacists providing preconception care with the use of TMRs.

Methods: Through the demonstration project, pharmacists provided educational TMRs focused on 3 elements of preconception care to women aged 15 to 45 years enrolled in a nonprofit managed care plan: (1) medications that may cause fetal harm (category D/X); (2) folic acid use; and (3) immunizations. TMRs were generated and released to the individual pharmacy where that patient had prescriptions filled. Any practicing pharmacist in Ohio participating in the medication therapy management platform with a patient in the sample received a TMR notification. The pharmacists documented and billed for the service through this commercially available platform.

Results: Nineteen weeks after implementation of the TMRs, 1149 individual pharmacists from 818 different pharmacies had completed at least 1 TMR. Pharmacists completed 33% of all TMR opportunities with a 65% success rate.

Conclusion: Establishing new services that were focused on preconception care resulted in rapid integration into existing medication therapy management processes in hundreds of pharmacies across Ohio. These results may help to provide justification for additional payers to reimburse for similar services. Through demonstrating the impact on preconception care, the role of the community pharmacist may continue to expand to include provision of additional preventive care services following the model developed in this initiative.