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Preconception care for women with epilepsy: a cross-sectional study comparing community and perinatal-certified
Hiroyuki Ura1, Noriko Matsuoka2, Yume Tozawa1
1Department of Clinical Pharmacy, Faculty of Pharmacy, Shonan University of Medical Sciences, Yokohama, Japan.
Background:
Preconception care (PCC) is essential for women with epilepsy (WWE) to reduce teratogenic risks and improve maternal and fetal outcomes. However, many WWE do not receive adequate counseling. Community pharmacists are well positioned to support PCC due to their accessibility, but their readiness for this role remains unclear.
Objective:
To assess self-efficacy, counseling depth, perceived barriers, and attitudes toward PCC among community pharmacists compared with perinatal-certified hospital pharmacists, and to identify modifiable factors to enhance community pharmacist participation.
Methods:
An anonymous online survey was conducted with 55 community pharmacists and 57 perinatal-certified pharmacists. Outcomes were measured using a 5-point Likert scale. Group differences were analyzed using Wilcoxon rank-sum tests, and path analysis was used to identify mediators of counseling behavior.
Results:
Community pharmacists showed lower self-efficacy, counseling depth, and engagement, along with higher perceived barriers; self-efficacy emerged as a key mediator of counseling behavior. Perinatal-certified pharmacists reported greater hesitation in addressing sensitive topics, suggesting a knowledge-hesitancy mechanism. Engagement was higher among community pharmacists working in collaborative care settings. Both groups supported earlier initiation of PCC and reimbursement for counseling services.
Conclusion:
Enhancing self-efficacy and addressing psychological barriers are critical to expanding the role of community pharmacists in PCC. Targeted strategies-including case-based education, structured communication approaches, collaborative care models, and reimbursement-may strengthen pharmacist-led PCC for WWE.
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