Knowledge of folic acid and counseling practices among Ohio community pharmacists
Objective: To determine knowledge of folic acid use for neural tube defect (NTD) prevention and counseling practices among community pharmacists registered in Ohio.
Methods: A cross-sectional study was performed on a random sample (n=500) of community pharmacists registered with the Ohio Board of Pharmacy and practicing in Ohio. A survey previously used by researchers to assess folic acid knowledge and practices among samples of other healthcare provider groups in the United States was adapted with permission for this study. The final tool consisted of 28 questions evaluating the knowledge, counseling practices, and demographics of respondents. The cover letter did not reveal the emphasis on folic acid, and surveys were completed anonymously. The university institutional review board deemed the study exempt.
Results: Of the 122 pharmacists who completed the survey, 116 (95.1%) knew that folic acid prevents some birth defects. Twenty-eight (22.9%) responded that they “always” or “usually” discuss multivitamins with women of childbearing potential, and 19 (15.6%) responded that they “always” or “usually” discuss folic acid supplements. Some gaps in knowledge specific to folic acid were revealed. While 63.1% of pharmacists selected the recommended dose of folic acid intake for most women of childbearing potential, 13.1% could identify the dose recommended for women who have had a previous NTD-affected pregnancy. Respondents identified continuing education programs, pharmacy journals/magazines, and the Internet as preferred avenues to obtain additional information about folic acid and NTD.
Conclusion: This study represents the first systematic evaluation of folic acid knowledge and counseling practices among a sample of pharmacists in the United States. As highly accessible healthcare professionals, community pharmacists can fulfill a vital public health role by counseling women of childbearing potential about folic acid intake. Educational materials may be beneficial in augmenting knowledge of folic acid and facilitating patient education.
2. Centers for Disease Control and Prevention. Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR Recomm Rep. 1992;41(RR-14):1-7.
3. United States Preventive Services Task Force. Folic acid for the prevention of neural tube defects: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;150(9):626-631.
4. Gallup Organization and March of Dimes Foundation. Improving preconception health: women’s knowledge and use of folic acid. [online] 2008; http://www.marchofdimes.com/peristats/pdfdocs/2008FolicAcidSurveyReport.pdf (accessed 21 October 2011).
5. De Van den Berg LTWJ, Van Der Zee AH, Schaafsma E, de Smit D, Anderson C, Cornel MC. Counselling women about periconceptional use of folic acid: the role of the community pharmacist can be improved. Int J Pharm Pract. 1999;7(3):138-142.
6. Egen V, Hasford J. Prevention of neural tube defects: Effect of an intervention aimed at implementing the official recommendations. Soz Praventivmed. 2003;48(1):24-32.
7. Bower C, Blum L, O'Daly K, Higgins C, Loutsky F, Kosky C. Promotion of folate for the prevention of neural tube defects: Knowledge and use of periconceptional folic acid supplements in Western Australia, 1992 to 1995. Aust N Z J Public Health. 1997;21(7):716-721.
8. Anderson C, Rajyaguru R. The role of community pharmacists and medicines counter assistants in health promotion: reflections from a folic acid campaign. Int J Pharm Pract. 2002;10(1):17-22.
9. Veenstra M, Hesselink JEC, Schaafsma E, de Van den Berg LTWJ. [Folic acid information in pharmacies leaves room for improvement: pharmacist's role in preventing neural tube defects.] Pharmaceutisch Weekblad 2000;135(4):118-121 [in Dutch].
10. Rosch C, Kastner S, Heinrich C, Steinbicker V. [Folic acid substitution: investigation of the knowledge of the pharmacists in Saxony-Anhalt.] Pharmazeutische Zeitung 2002;147:28-30,32,CP2 [in German].
11. Kondo A, Yamamoto HI, Watanabe J, Tada K, Yoshimoto N. Folic acid in the prevention of neural tube defects: awareness among laywomen and healthcare providers in Japan. Congenit Anom (Kyoto). 2009;49(3):97-101.
12. Williams JL, Abelman SM, Fassett EM, Stone CE, Petrini JR, Damus K, Mulinare J. Health care provider knowledge and practices regarding folic acid, United States, 2002–2003. Matern Child Health J. 2006;10(5 Suppl):S67-S72.