Peripartum mental health and the role of the pharmacist: A scoping review

BACKGROUND: The global prevalence of peripartum mental illness is 20%, though estimates have increased since the start of the COVID-19 pandemic. Chronic illnesses affect one in five pregnancies and may be associated with higher rates of peripartum mental illness. Though pharmacists are well-positioned to facilitate appropriate and timely care of co-occurring mental and physical health conditions during this period, little is understood regarding their potential roles. OBJECTIVES: To understand the current evidence examining the role of pharmacists to improve the outcomes of women with peripartum mental illness, with and without chronic illness. METHODS: A scoping review was performed with assistance from an interdisciplinary team following the Joanna Briggs Institute framework. MEDLINE, Embase, PsychNet and International Pharmaceutical Abstracts databases were searched. English-language articles (published up to May 30, 2022) were screened and assessed for eligibility, and data were charted to collate results, by dual independent reviewers. RESULTS: The search strategy produced 922 articles. After screening, 12 articles were included (5 narrative reviews, 7 primary research). There was limited discussion or empirical data regarding specific interventions (screening, counseling), opportunities (accessibility, managing stigma, forming trusting relationships and building rapport with patients) or barriers (lack of privacy, time constraints, adequate remuneration, training) associated with an expanded role of pharmacists in peripartum mental health care. The clinical complexity arising from co-occurring mental health and chronic illnesses was not explored, other than a small pilot study involving pharmacists screening for depression among pregnant women with diabetes. CONCLUSIONS: This review highlights the limited evidence available on the explicit role of pharmacists in supporting women with peripartum mental illness, including those with comorbidity. More research, including pharmacists as study participants, is required to fully understand the potential roles, barriers, and facilitators of integrating pharmacists into peripartum mental healthcare to improve the outcomes of women in the peripartum period.