Mrs Claudia Steinbock1, Ms Stephanie Hoy1, Dr Keeri Young1, Mrs Noor Aladhami1
1Rbwh Pharmacy, Herston, Australia
Biography:
Biographies to come
Abstract:
Purpose: Demonstrate the impact of an obstetric pharmacist in the maternity outpatient's clinic on the quality and continuity of care of vulnerable and high-risk antenatal patients.
Nature and scope: A pharmacy service was established to provide continuity of care for high-risk pregnant patients from preconception to postpartum period at a tertiary hospital.
Historically pharmacists would take medication histories and provide expert advice in the obstetric medicine clinics. The pharmacy service has extended to include obstetric cardiac, mental health and Indigenous patients, as well as patients under GP shared-care, midwifery-led care and mental health patients. A pharmacist vaccination service for pertussis and influenza vaccination has been established, the first of its kind in Australia.
Issue or problem: Obstetric patients not admitted under specialist care model were found to have suboptimal management of their medications due to safety concerns and lack of specialist information, leading to a deterioration in patient wellbeing and increasing pregnancy complications. Low antenatal vaccination rates amongst vulnerable patient cohorts (e.g. prisoners) were noted, increasing health risks of the unborn child in the first months of life.
Outcome or conclusion:
The extension of pharmacist service facilitated provision of specialist clinical expertise, medication advice and reassurance to a wider range of patients through face to face, phone or telehealth consultations. Working in collaboration with the multidisciplinary team, as well as GPs in community, the pharmacist continuously contributes to decision making regarding complex medications for high-risk patients. This includes patients with complex mental health background, managed through the Metro North mental health team, leading to increased compliance and improved patient outcomes. Working at advanced scope of practice, the pharmacist vaccinators have provided more than 500 pertussis and influenza vaccinations annually, increasing the uptake of vaccinations in pregnancy and decreasing the risk of severe illness for the newborns.
Keywords
"antenatal", "specialist", "pharmacy"