Background
Community pharmacies are often the first port of call for women who are thinking of becoming pregnant or for those who are testing for success. This is the ideal time for them to receive advice on taking folic acid, vitamin D, healthy eating and exercise, improving oral health, smoking cessation and reduction/abstinence of alcohol and other substances. A wrap-around package of care aligned to several STP priorities and supporting self-care can easily be provided in this setting.
Early booking for antenatal is important. NICE states this should start at 10 weeks. But studies show a significant number of women are late attenders. Health profiles for NW London describe high deprivation, children under 16, smoking and alcohol use. Pharmacists will encourage early booking and also provide free flu vaccinations under an existing service commissioned by NHS England.
During the perinatal period, women will receive advice on breastfeeding, oral health, mental health care, and immunisations such as MMR in the early years.
Aims
To demonstrate that community pharmacies can become recognised places where women can obtain support, advice and information relating to preconception, pregnancy, antenatal, perinatal and early years’ care as a package.
Methods
Across Brent, Harrow and Hillingdon, 30 pharmacies are participating in the scheme. Pharmacists and their health champions have been trained by Imperial College London and lead midwives to ensure appropriate competencies in all aspects of this package. Promotion of the scheme and referral of women to the participating pharmacies is being supported by local midwives, antenatal clinics, health visitors, children’s commissioners and public health leads. A dedicated website is set up by Sonar Informatics to support the service: http://www.pharmacy4mums2b.org.uk/
Registration of customers began in February 2018. Advice and support on all relevant issues is being provided, including:
During pregnancy:
Early booking for antenatal care. Folic acid and Vitamin D, free dental treatment, flu and pertussis vaccinations, healthy eating, exercise, alcohol reduction/abstinence, smoking cessation, stopping other harmful substances. Downloading and using free apps such as Baby Buddy and MatImms.
Taking prescription medicines and OTC medication for pain management and nausea.
Perinatal period:
Healthy eating, exercise, alcohol reduction/abstinence, smoking cessation, stopping other harmful substances and adherence to appropriate medication.
Early years:
Breast feeding, baby milk and feeds, MMR, use of MatImms and Baby Buddy, and if appropriate, advice on free vitamins from national Healthy Start Vitamin programme.
Oral Health: The importance of visiting the dentist as soon as practicable to get babies used to the process, selecting baby feeds, healthy feeding for infant, importance of brushing teeth with fluoride toothpaste, avoiding sugary feeds, sweet drinks, fruit juice and squash
Feedback from all stakeholders will be analysed, and evaluation completed by Imperial College London.
Intended Outcomes
Women in this group should feel better informed. Feedback should show lifestyle changes resulting from the pharmacy support, such as early booking for antenatal, taking nutritional supplements where they might not have been considered before, using new apps, visiting the dentist and having the appropriate vaccinations
Middlesex Group of LPCs 10th January 2019
Evaluation
Pharmacy4mums2B has now been evaluated by Professor Mitch Blair and his team at Imperial College, London. The evaluation can be viewed here.