Brief counseling by pharmacists enhances the knowledge, perceptions, and compliance of first and second-trimester pregnant women consuming ferrous fumarate at Jetis Community Health Center of Yogyakarta

Abstract

In Indonesia, the prevalence of anemia during pregnancy increased from 37.1% in 2013 to 48.9% in 2018. It plays a significant part in elevated maternal mortality and perinatal rates. This research aimed to determine the influence of a brief counseling intervention by pharmacists based on the "5A" strategy that had been modified to include the knowledge, perceptions, and compliance of pregnant women with the recommended consumption of ferrous fumarate as anemia treatment and prevention. It is a quasi-experimental study with a pretest-posttest control group design. The data were collected prospectively from December 2018 to February 2019. The sample consisted of 26 respondents, divided into a control group and an intervention group. Each group comprised 13 pregnant women in their first and second trimester (ranging from 12 to 27 weeks). The knowledge, perceptions, and compliance in each group were measured on the first day of visit (Day 1; pretest) and Day 31 (posttest) after the intervention. The results showed a significant difference in average scores between the pretest and posttest in the intervention group (p<0.001 for knowledge, perceptions, and compliance parameters) but an insignificant difference in the control group (p=0.185, p=0.366, and p=0.111, respectively). Score difference or improvement was determined from the relative risk (RR) values of the three parameters (4. 55, 4.54, and 10.29, respectively, with p<0.50). As a conclusion, a brief counseling intervention based on the modified "5A" strategy can enhance the knowledge, perceptions, and compliance of first and second-trimester pregnant women at Jetis Community Health Center with the proper consumption of Fe fumarate as an iron supplement.

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

“…The literature search identified 1478 articles, and an additional two articles were identified through searching of reference lists. Following screening of titles and abstracts, ten articles were eligible for full text screening, of which four were included [ 20 , 21 , 22 , 23 ] and six excluded [ 16 , 17 , 24 , 25 , 26 , 27 ]. Reasons for exclusion included incorrect intervention setting, inappropriate study design or a target population that did not include pregnant women or those planning pregnancy.…”

“…The characteristics of included studies are summarised in Table 2 . These studies included a randomised pre–post control design [ 20 ], a quasi-experimental pretest–posttest control group design [ 23 ], a pilot study with randomly allocated intervention and reference pharmacies [ 21 ], and a pilot study without a control group [ 22 ]. The studies were conducted in Indonesia [ 20 , 23 ], the Netherlands [ 21 ] and Scotland [ 22 ], respectively.…”

“…These studies included a randomised pre–post control design [ 20 ], a quasi-experimental pretest–posttest control group design [ 23 ], a pilot study with randomly allocated intervention and reference pharmacies [ 21 ], and a pilot study without a control group [ 22 ]. The studies were conducted in Indonesia [ 20 , 23 ], the Netherlands [ 21 ] and Scotland [ 22 ], respectively. The study aims were to improve adherence to iron supplement tablets (ISTs) and improve haemoglobin (Hb) levels during pregnancy [ 20 ], improve the knowledge and use of ferrous fumarate during pregnancy [ 23 ], promote smoking cessation during pregnancy [ 22 ], and improve the knowledge and use of folic acid supplements before pregnancy [ 21 ].…”

“…The studies were conducted in Indonesia [ 20 , 23 ], the Netherlands [ 21 ] and Scotland [ 22 ], respectively. The study aims were to improve adherence to iron supplement tablets (ISTs) and improve haemoglobin (Hb) levels during pregnancy [ 20 ], improve the knowledge and use of ferrous fumarate during pregnancy [ 23 ], promote smoking cessation during pregnancy [ 22 ], and improve the knowledge and use of folic acid supplements before pregnancy [ 21 ]. The duration of the interventions varied from 30 days [ 20 , 23 ] to 6 months [ 21 , 22 ].…”

“…One study recruited women before pregnancy [ 21 ], whilst three recruited pregnant women [ 20 , 22 , 23 ], with one study specifically including women in the first and second trimesters [ 23 ]. Women were recruited through community pharmacies and community health centres.…”