Cutting-Edge Practice

Pharmacist Provision of Preconception Care via Medication Therapy Management

State/Jurisdiction: Ohio
Setting: Clinical
Population: Women/Maternal Health,
Topic Area: Reproductive Health,

A project was conducted in Ohio to demonstrate the feasibility of pharmacist-directed preconception care. Targeted interventions known in medication therapy management (MTM) programs as targeted medication reviews (TMRs) were developed to educate patients on three aspects of preconception care: teratogenic medication use, folic acid use, and immunizations using an existing MTM framework. Females aged 15-45 years enrolled in a managed Medicaid program in Ohio in need of receipt of at least one of the educational interventions were identified. Through an MTM platform, TMRs were generated and sent electronically to the community pharmacy where the patient had prescriptions filled to alert them to initiate patient counseling and education. Once opened, the pharmacist received a detailed reason for the proposed intervention, action needed, and options for taking action on the targeted intervention. After addressing the intervention, the pharmacist documented the outcome of the service (patient education provided; unable to reach patient; patient refused; or no intervention needed) and billed as appropriate per the requirements of the MTM platform. Follow-up services could be billed by the pharmacist for related interventions identified through the patient education process. After 62 weeks, a total of 2,444 pharmacists in 1,359 pharmacies across Ohio successfully delivered 21,833 educational interventions. The Pharmacist Provision of Preconception Care via Medication Therapy Management project demonstrates the feasibility of community pharmacist provision of preconception services via MTM and suggests that this project may be replicated in other states. Although one-third to one-half of Americans have no medical home, the average American lives within 5 miles of a community pharmacy. Yet, community pharmacists are often over-looked as potential partners for many MCH initiatives. This successful model raises awareness about opportunities to capitalize on the pharmacy workforce to reach the public and can be expanded to include other aspects of preconception care as well as the provision of additional preventive care services by community pharmacists. Please contact Natalie DiPietro Mager, Ohio Northern University Raabe College of Pharmacy ( and David Bright, Ferris State University College of Pharmacy ( for more information. Additionally, the following peer-reviewed publications describe the project: (1) DiPietro Mager NA, Bright DR,et al. Use of targeted medication reviews to deliver preconception care: A demonstration project. Journal of the American Pharmacists Association. 2017;57(1):90-94. (2) Bright DR, DiPietro Mager NA. Preconception care and contraception services: Opportunities for community pharmacists. Journal of the American College of Clinical Pharmacy. 2019;2:414–422.

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Implementation Handout
Idea Paper

Ohio Northern University Raabe College of Pharmacy
Natalie DiPietro Mager, PharmD, PhD
Practice Website
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