The use of insulin, considered a high-risk medication with APINCHs classification,5 Ms Barwick notes, provides justification for a Home Medicines Review (HMR). ‘There’s an advantage to going into the home to observe the patient’s diet, consider potential interactions, and educate patients on the best effects and outcomes,’ she says.
Advice around cleaning blood glucose level (BGL) monitors to ensure accuracy can also be provided. ‘Pharmacists can explain how to put test drops through and clean blood spills on the monitor, common in pregnancy due to higher blood volume,’ says Ms Barwick.
With only 50% of women diagnosed with GDM receiving tests for heart disease and type 2 diabetes post-pregnancy,6 HMRs can be beneficial at this stage of the journey, too.
‘Along with conversations around diet choices, exercise regimes and sleep, I also explain how often testing is required over the next 5–10 years, and how to monitor for signs of the development of diabetes,’ Ms Barwick advises.
Nausea and vomiting in pregnancy
The presence of iron in pregnancy multivitamins may exacerbate symptoms of nausea and vomiting in some pregnancies, according to Ms Barwick.
‘Pharmacists can recommend a trial cessation of the iron component of pregnancy vitamins, often unnecessary in pregnancy,’ she says.
In 2020, photographer Bobbi Lockyer created a Birthing on Country project to highlight and create awareness around birthing issues and outcomes in Aboriginal women. For more, see 
Suzanne Nielsen MPS[/caption]
Case Scenario
Josh is a 35-year-old man who picks up his escitalopram 20 mg from your pharmacy. He started this medication 3 months ago after being diagnosed with depression for the first time and is not taking other medications. During his visit to your pharmacy, you have observed that he is unkempt, tired, has a downward gaze, and is about 3 weeks late for his prescription refill. Upon chatting to Josh, you find that he is not doing well. He has been struggling at work, not sleeping well, and thinks the antidepressant is not working. He cannot be bothered attending his clinical psychologist appointments. On further questioning, he discloses having a couple of drinks most nights to help him sleep, and that he does not like taking escitalopram due to the sexual dysfunction adverse effects.
Learning ObjectivesAfter reading this article, pharmacists should be able to:
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