Anemia is a major public health problem among pregnant women, particularly in low- and middle-income countries. It is characterized by a reduction in hemoglobin concentration or the oxygen-carrying capacity of the blood, which may be insufficient to meet the physiological needs of the body. Maternal anemia is associated with an increased risk of adverse maternal and fetal outcomes.
Despite the high prevalence of anemia among pregnant women, poor medication adherence and inadequate understanding of prescribed therapy may limit treatment effectiveness. Pharmacists can play an important role in providing medication-related education, improving patients' understanding of their treatment, identifying barriers to adherence, and promoting appropriate medication use. However, evidence on pharmacist-led educational interventions to improve medication adherence and hemoglobin levels among anemic pregnant women in Pakistan remains limited.
Therefore, this randomized controlled trial will be conducted to evaluate the effect of a structured pharmacist-led educational intervention on medication adherence and hemoglobin levels among anemic pregnant women in District Chakwal, Punjab, Pakistan.
A total of 100 eligible pregnant women diagnosed with anemia will be recruited and randomly allocated into intervention and control groups. Participants in the intervention group will receive a structured pharmacist-led educational intervention in addition to routine care, while participants in the control group will receive routine antenatal care and standard anemia management.
Medication adherence and hemoglobin levels will be assessed at baseline and after the intervention. The study will determine whether pharmacist-led educational counseling improves medication adherence and hemoglobin levels compared with routine care.
Data will be analyzed using IBM SPSS Statistics version 26. A paired-sample t-test will be used to compare changes in continuous variables, particularly hemoglobin levels, between baseline and post-intervention assessments. McNemar's test will be used to assess changes in paired categorical variables, including medication adherence where appropriate. A p-value of \<0.05 will be considered statistically significant.
Pregnant woman
Hb <11g/dl
Having Punjab domicile-
Patients with co-morbidities
Patients with Hb >11g/dl
Outside the Punjab domicile
Single group
Pharmacist-led counseling on anemia management
Other interventionIntervention Description: Patients will receive individualized pharmacist-led counseling regarding anemia management, medication adherence, appropriate use of prescribed medicines, dietary measures, and strategies to improve quality of life. Outcomes will be assessed before the intervention and at one-month follow-up. Study Design: Single-arm, pre-post evaluation.
Change in hemoglobin concentration
Description: Change in hemoglobin (Hb) concentration from baseline to one-month follow-up, measured in g/dL using a laboratory hemoglobin test.
Change in anemia severity
Description: Change in anemia severity from baseline to one-month follow-up, categorized according to the participant's measured hemoglobin concentration using the predefined diagnostic criteria for anemia.
Medication adherence
Description: Change in medication adherence from baseline to one-month follow-up, assessed using the \[name of your actual validated adherence scale/questionnaire\].
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