Safe lists for medications in pregnancy: inadequate evidence base and inconsistent guidance from Web‐based information, 2011

Peters, Stacey; Lind, Jennifer N.; Humphrey, Jasmine R.; Friedman, Jan M.; Honein, Margaret A.; Tassinari, Melissa S.; Moore, Cynthia A.; Mathis, Lisa L.; Broussard, Cheryl S.

doi:10.1002/pds.3410

Cited by 46 publications

(46 citation statements)

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“…However, in each case, we do not know which source came first, in which order the information was sought, or the actual content of the information received. There is evidence of a lack of consistency between information on drug safety during pregnancy based on different information sources [23-25]. For example, according to the study by Frost Widnes and Schjøtt [24], the Norwegian Compendium on Product Monographs gives advice which is more restrictive than that given by drug information centers.…”

Section: Discussionmentioning

confidence: 99%

Multiple Information Sources and Consequences of Conflicting Information About Medicine Use During Pregnancy: A Multinational Internet-Based Survey

Hämeen‐Anttila¹,

Nordeng²,

Kokki³

et al. 2014

J Med Internet Res

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BackgroundA wide variety of information sources on medicines is available for pregnant women. When using multiple information sources, there is the risk that information will vary or even conflict.ObjectiveThe objective of this multinational study was to analyze the extent to which pregnant women use multiple information sources and the consequences of conflicting information, and to investigate which maternal sociodemographic, lifestyle, and medical factors were associated with these objectives.MethodsAn anonymous Internet-based questionnaire was made accessible during a period of 2 months, on 1 to 4 Internet websites used by pregnant women in 5 regions (Eastern Europe, Western Europe, Northern Europe, Americas, Australia). A total of 7092 responses were obtained (n=5090 pregnant women; n=2002 women with a child younger than 25 weeks). Descriptive statistics and logistic regression analysis were used.ResultsOf the respondents who stated that they needed information, 16.16% (655/4054) used one information source and 83.69% (3393/4054) used multiple information sources. Of respondents who used more than one information source, 22.62% (759/3355) stated that the information was conflicted. According to multivariate logistic regression analysis, factors significantly associated with experiencing conflict in medicine information included being a mother (OR 1.32, 95% CI 1.11-1.58), having university (OR 1.33, 95% CI 1.09-1.63) or other education (OR 1.49, 95% CI 1.09-2.03), residing in Eastern Europe (OR 1.52, 95% CI 1.22-1.89) or Australia (OR 2.28, 95% CI 1.42-3.67), use of 3 (OR 1.29, 95% CI 1.04-1.60) or >4 information sources (OR 1.82, 95% CI 1.49-2.23), and having ≥2 chronic diseases (OR 1.49, 95% CI 1.18-1.89). Because of conflicting information, 43.61% (331/759) decided not to use medication during pregnancy, 30.30% (230/759) sought a new information source, 32.67% (248/759) chose to rely on one source and ignore the conflicting one, 25.03% (190/759) became anxious, and 2.64% (20/759) did nothing. Factors significantly associated with not using medication as a consequence of conflicting information were being pregnant (OR 1.75, 95% CI 1.28-2.41) or experiencing 3-4 health disorders (OR 1.99, 95% CI 1.10-3.58). Women with no chronic diseases were more likely not to take medicines than women with ≥2 chronic diseases (OR 2.22, 95% CI 1.47-3.45). Factors significantly associated with becoming anxious were >4 information sources (OR 2.67, 95% CI 1.70-4.18) and residing in Eastern Europe (OR 0.57, 95% CI 0.36-0.90).ConclusionsAlmost all the pregnant women used multiple information sources when seeking information on taking medicines during pregnancy and one-fifth obtained conflicting information, leading to anxiety and the decision not to use the medication. Regional, educational, and chronic disease characteristics were associated with experiencing conflicting information and influenced the decision not to use medication or increased anxiety. Accurate and uniform teratology information should be made more available ...

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Section: Discussionmentioning

confidence: 99%

Multiple Information Sources and Consequences of Conflicting Information About Medicine Use During Pregnancy: A Multinational Internet-Based Survey

Hämeen‐Anttila¹,

Nordeng²,

Kokki³

et al. 2014

J Med Internet Res

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“…Inadequate dissemination of appropriate advice describing which drugs may be continued can lead to women unnecessarily forgoing potentially helpful medications and thus suffering throughout pregnancy, with the increased risk of further complications to both mother and child due to the effects of active disease 26. Furthermore, patients are increasingly seeking additional information on the internet,27 while a recent analysis of information regarding medication safety on active internet sites has noted an inadequate evidence base for the advice often provided and inconsistent guidance 28. It is clear that communication of reliable and consistent information is required to enable the correct treatment of these women before and during pregnancy, and while breastfeeding.…”

Section: Introductionmentioning

confidence: 99%

Family planning and pregnancy issues for women with systemic inflammatory diseases: patient and physician perspectives

et al. 2014

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ObjectivesTo identify family planning and pregnancy (FPP) issues for female patients of childbearing age living with a chronic inflammatory disease and to assess whether current clinical practice routinely provides adequate support to alleviate these concerns.SettingMultinational survey and an analysis of online patient activity.ParticipantsPremenopausal women (aged 20–45 years; N=969) were surveyed in the USA, the UK, Germany, France, Italy and Spain. Rheumatologists were surveyed in Germany (N=50), France (N=50), Italy (N=50) and the USA (N=100), and gastroenterologists were also surveyed in the USA (N=100).Primary and secondary outcome measuresTwo online surveys were undertaken to identify FPP issues for physicians and patients. The surveys examined the frequency of dialogue on these topics between physicians and patients, alongside assessment of patient satisfaction regarding these conversations. Online analysis identified key themes for patient discussion outside their doctors’ office/clinic/surgery.Results32–56% of physicians spontaneously reported having talked about FPP with their female patients of childbearing age. When prompted, the majority of rheumatologists (74–92%) and gastroenterologists (74%) reported having discussed conception/pregnancy with female patients; however, less than half reported consulting their patient's treating general practitioner/gynaecologist about these topics. The majority of patients reported their FPP-related concerns are not adequately addressed/settled during their medical appointments. Furthermore, only 30–40% of patients considered advice/information to be consistent across multiple healthcare professionals. Key online FPP-related patient discussions included disease state, adverse effects, treatment, switch behaviour and wash-out requirements.ConclusionsFemale patients who live with chronic inflammatory disease have important FPP concerns. The majority of patients, however, do not feel that their FPP concerns are adequately addressed in current clinical practice and report that they receive inconsistent advice from the various healthcare professionals who manage different aspects of their care. There is a clear need for provision of up-to-date and consistent information/support to female patients.

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“…These findings are worrisome as neither the Internet or health food store sources have been found to be solid sources of reliable information. A recent study examined websites providing lists of prescription medications reported to be safe during pregnancy; inconsistent and inaccurate information about those drugs was found (Peters et al, 2013). With even less empirical data related to CAM therapies it is likely that Internet information is largely inaccurate as well.…”

Section: Discussionmentioning

confidence: 99%

Decision-making for use of complementary and alternative therapies by pregnant women and nurse midwives during pregnancy: An exploratory qualitative study

Hastings‐Tolsma¹

2013

Int. J. Nurs. Midwifery

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Millions of people use complementary and alternative medicine (CAM) therapies. Such therapies are used across a wide spectrum of health conditions, but the use is particularly notable during pregnancy. Despite the widespread use, little is known about the perceptions of patients and clinicians in deciding about use of varied therapies. This study describes pregnant women and obstetrical provider (nurse midwives) perceptions in decision-making for use of CAM therapies during pregnancy. Pregnant women and nurse midwives were interviewed in focus groups with transcribed data analyzed using content analysis. Four themes emerged from the session with pregnant women and 3 from the nurse midwives. Data underscore the need to dialogue with all pregnant women about CAM use, and to mainstream CAM in education programs. Given the paucity of evidence for safety and efficacy during pregnancy for most CAM therapies, decision-making strategies to fill those knowledge gaps are urgently needed.

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Safe lists for medications in pregnancy: inadequate evidence base and inconsistent guidance from Web‐based information, 2011

Cited by 46 publications

References 9 publications

Multiple Information Sources and Consequences of Conflicting Information About Medicine Use During Pregnancy: A Multinational Internet-Based Survey

Multiple Information Sources and Consequences of Conflicting Information About Medicine Use During Pregnancy: A Multinational Internet-Based Survey

Family planning and pregnancy issues for women with systemic inflammatory diseases: patient and physician perspectives

Decision-making for use of complementary and alternative therapies by pregnant women and nurse midwives during pregnancy: An exploratory qualitative study

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