Perinatal Women’s Views of Pharmacist-Delivered Perinatal Depression Screening

The “baby blues” is a common term used to illustrate mood changes and feelings of worry, sadness, and fatigue that some women feel during the first 2 weeks postpartum. Severe depressed mood or symptoms lasting beyond 2 weeks may indicate postpartum depression and patients should seek treatment.

Perinatal depression (PND) appears during or after pregnancy. One in 10 women experience depression in their lifetime, which is twice the depression rates in men.¹ The perinatal period—the time during pregnancy and up to 12 months after delivery—is the most vulnerable time for onset; 20% of women experience PND internationally.

PND may be associated with negative outcomes for the infant, including low birthweight, premature delivery, poor cognitive performance, and behavior problems. PND can affect the quality of parenting, which leads to decreased parental involvement/warmth and increased risk of child maltreatment.

In Australia, 80% of women with PND receive support or treatment. One in 5 women do not receive mental health screening despite growing screening rates.

More resources and involvement from a broad range of health care providers are needed to adequately capture high-risk populations for early detection and intervention. Trusted, accessible pharmacists are ideally positioned within communities to identify patients struggling with PND.

A recent study published in the International Journal of Environmental Research and Public Health investigated perinatal women’s views of community pharmacist-delivered PND screening and care in Australia. The study’s results could be crucial in developing relevant services.

The research team’s interview questions collected demographics, personal experience with PND screening, PND awareness, relationship with pharmacists, and appropriateness of pharmacist-delivered PND screening and care. Participants were eligible for inclusion if they were Australian residents and pregnant or up to 12 months postpartum.

Several common themes emerged from the 41 participants’ responses. These responses related to:

• Patients’ experiences with current PND support and screening services.
• Patients’ perceptions of pharmacists’ roles.
• Visibility of pharmacist-run PND screening care.
• Patient-pharmacist relationships.
• Factors affecting service accessibility.

Many participants viewed pharmacists’ roles as medication-centered. Increasing patient awareness of pharmacists’ full scope of practice may improve patient-pharmacist relationships.

Women agreed that increased support from primary health care providers may increase the likelihood of patient acceptance of pharmacist-delivered PND screening and care. Barriers are lack of privacy, time constraints, and cost.

One in 5 Australian women are still not being screened for PND. In the United States, 50%–70% of women with PND are not identified or diagnosed, and 85% go untreated.² The study results show that women see value in pharmacist-delivered PND screening when there is training, transparency, and support from members of the primary health care team.

Pharmacists have the capacity to expand primary preventive care by offering PND screening, which may increase PND care accessibility and improve maternal and fetal outcomes.

About the Author

Dr. Tolliday is team lead, Outpatient Pharmacy, at Wentworth-Douglass Hospital in Dover, NH.

References

1. National Institute of Mental Health. Perinatal Depression. U.S. Department of Health and Human Services, National Institute of Mental Health. Published 2021. Accessed December 27, 2022. https://www.nimh.nih.gov/health/publications/perinatal-depression

2. Dagher RK, Bruckheim HE, Colpe LJ, Edwards E, White DB. Perinatal Depression: Challenges and Opportunities. J Womens Health (Larchmt). 2021;30(2):154-159. doi:10.1089/jwh.2020.8862