Abstract
Domperidone is a commonly prescribed galactagogue used off-label for lactation insufficiency. Prescriber unfamiliarity or safety concerns can lead to therapeutic delay and potential early breastfeeding discontinuation. To facilitate access, the study site pharmacy department developed a structured administration and supply arrangement (SASA) for International Board Certified Lactation Consultants to screen and initiate domperidone using a checklist. The study aimed to validate a domperidone screening tool via an analysis of its use and compliance. Records were extracted from the RedCAP® database for the first 50 women with a documented domperidone supply and reviewed against medical records. A staff survey was distributed assessing compliance and attitudes towards the SASA. Records of supply from the RedCAP® database revealed 34% (17/50) of patients were referred to a physician, revealing a discrepancy between RedCAP® reporting and checklists as no referrals were documented. Overall staff satisfaction with the SASA was rated 4.6/5. In total, 77.7% (7/9) felt confident counselling and supplying domperidone with the SASA in place, and 88.9% (8/9) felt confident using the checklist to identify the appropriateness of therapy and referral to a physician. Only 55.6% (5/9) indicated the checklist was used with each screening. The SASA education package is being updated to clarify the requirements for checklist completion and standardise frameworks to document follow-up.
Author Contributions
Conceptualization, S.W.K.T. and T.L.; methodology, S.W.K.T. and T.L.; formal analysis, K.C.; data curation, K.C.; writing—original draft preparation, K.C.; writing—review and editing, S.W.K.T., T.L. and M.K. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki and approved by the Women and Newborn Health Service Quality Improvement Committee of King Edward Memorial Hospital on 7 March 2023 (approval number: GEKO 49245).
Informed Consent Statement
Participant Information Form was obtained from all staff members involved in the staff survey. Patient consent was waived with deidentified patient information in the study and deemed Low and/or Negligible Risk Research/Activities by the Quality Improvement Committee of King Edward Memorial Hospital.
Data Availability Statement
Data are contained within the article.
Acknowledgments
The authors would like to acknowledge the contribution of the pharmacy staff and International Board Certified Lactation Consultants at King Edward Memorial Hospital in documenting their valuable and critical work for the health service.
Conflicts of Interest
The authors declare no conflicts of interest.
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