Aims
To investigate the roles and actions of, and barriers to, pharmacists participating in a diabetes contraception and pre-pregnancy program (DCAPP) in South-West Sydney (SWS)).
Methods
Pharmacists were recruited through direct approach during the SWS implementation programme. Women with type 1 (T1DM) or Type 2 (T2DM) diabetes aged 18-50 years were recruited from diabetes in pregnancy and transition clinics. Pharmacists pre- and post-exposure to DCAPP, and women with diabetes, completed semi-structured questionnaires and one on one interviews/focus group regarding perceptions of the pharmacist role in pre-pregnancy and contraception care for women with diabetes. Data were collected until saturation in themes was found. Thematic analyses were undertaken.
Results
Both pharmacists (11 pharmacists pre- and 11 post-DCAPP implementation from throughout SWS) and women (n=12) saw a need for increased knowledge, coordination of services, educational materials and information sessions run at pharmacies. Pharmacists also saw a need for Blood glucose (BG) testing at pharmacies and better education about effective BG monitoring. Some pharmacists recognised deficits in their knowledge for this specific population; more than half did not know the correct folate dose for women with diabetes, were unsure how management of pre-existing diabetes in pregnancy differed to gestational diabetes, and had difficulties identifying what complications women were at risk of. Barriers to involvement of pharmacists in pre-pregnancy care included difficulty identifying the target population, and reluctance to initiate pregnancy planning and contraception conversations, often due to language and cultural barriers.
Conclusion
Both women with T1DM and T2DM and pharmacists can see an important role for pharmacists to be involved in contraception and pre-pregnancy care; this was seen to involve distribution of information and referral to pre-pregnancy clinics. Further diabetes training for pharmacists and involvement of them in the design of a program were seen to be important for ongoing DCAPP implementation.