Developing ambulatory care clinical pharmacy services in an obstetrics and gynecology clinic in a safety net health system

Background

The United States is facing a maternal health crisis with 23.5 maternal deaths for every 100,000 births. Ambulatory care clinical pharmacists are uniquely positioned and skilled to help increase access to care before, during, and after pregnancy through chronic disease management. However, there are gaps in the current literature regarding pharmacists’ independent prescribing of medications, development of a collaborative practice agreement (CPA), and integration into an obstetrics and gynecology (OBGYN) clinic within a safety net health system.

Objective

This study aimed to describe the implementation of an OBGYN clinic pilot program.

Methods

This was a pilot program implemented by a second-year ambulatory care pharmacy resident from November 2023 to June 2024. The implementation steps included identifying key stakeholders, creating a CPA, and establishing clinic presence.

Results

The pharmacy resident provided services such as answering drug information questions, conducting one-on-one patient appointments, and helping with sustainable medication access once they were integrated into the clinic. The resident received 5 referrals, which led to 7 scheduled appointments. Of these scheduled appointments, 3 patients did not show up, 3 initial appointments were completed, and 1 follow-up appointment was completed. The 3 completed appointments were for contraception management, hyperemesis management during pregnancy, and postpartum diabetes management.

Conclusion

Developing clinical pharmacy services within a clinic requires several steps, including meeting with key stakeholders, creating a CPA, and providing education on the service. More information is needed to provide a model for the sustainability of pharmacist services within OBGYN clinics.