Using Web-Based Questionnaires to Assess Medication Use During Pregnancy: A Validation Study in 2 Prospectively Enrolled Cohorts

Abstract

Medication use is often underreported in paper-based questionnaires or interviews. Web-based questionnaires may improve recall of medication use, but data on their validity are currently lacking. Participants in the Pregnancy and Infant Development (PRIDE) Study (2014-2016; n = 557) and the Pregnancy Drug Registry (pREGnant) (2015-2016; n = 169) completed a 6-week paper-based medication diary during gestational weeks 19-24 or 26-31. In week 34, they completed a Web-based questionnaire with questions on medication names, time period and frequency of use, and quantity taken. To assess the degree of underreporting, we calculated the questionnaire's sensitivity using the medication diary as the reference standard. Sensitivity was high for many medication groups, including antiepileptic medication (sensitivity (Sn) = 0.96, 95% confidence interval (CI): 0.89, 1.00), antacids (Sn = 0.89, 95% CI: 0.86, 0.93), and iron preparations (Sn = 0.81, 95% CI: 0.64, 0.98). However, medications for short-term use were underreported more frequently, with sensitivities of 0.54 (95% CI: 0.35, 0.72) for antihistamines, 0.63 (95% CI: 0.57, 0.69) for analgesic and antipyretic agents, and 0.57 (95% CI: 0.51, 0.64) for acetaminophen. Shortening the period of time between exposure and questionnaire administration increased sensitivity substantially. In conclusion, underreporting in Web-based questionnaires is limited for many medication groups. In prospective studies, underreporting of medications for short-term use may be reduced by decreasing the interval between consecutive questionnaires.

Social media monitoring on the perceived safety of medication use during pregnancy: A case study from the Netherlands

“…This seems to largely agree with the medications most often used during pregnancy in Europe and North America . Although valid prevalence estimates of OTC medication use during pregnancy in the Netherlands are not available, ibuprofen use during pregnancy, which is contraindicated, seems far less common in the Netherlands compared to the USA (<2 vs >15%, respectively), whereas this medication was often mentioned in the Dutch online posts. Therefore, mentions in online posts do not imply actual medication use and these results cannot be extrapolated to indicate which medications are most often used during pregnancy in the Netherlands.…”

“…This seems to largely agree with the medications most often used during pregnancy in Europe and North America 3,[28][29][30][31]. Although valid prevalence estimates of OTC medication use during pregnancy in the Netherlands are not available, ibuprofen use during pregnancy, which is contraindicated, seems far less common in the Netherlands compared to the USA (<2 vs >15%, respectively),20,32 whereas this medication was often mentioned in the Dutch online posts. Therefore, mentions in online posts do not imply actual medication use and these results cannot be extrapolated to indicate which medications are most often used during pregnancy in the Netherlands.In addition to the ability to review posts on multiple social media platforms, other strengths of this study include the predefined selection of prescription and OTC medications based on real-world data and the inclusion of a wide variety of maternal complications and adverse pregnancy outcomes.…”

“…The search strategy consisted of the following elements: (i) a pregnancy‐related term; (ii) commonly used medications during pregnancy; and (iii) a maternal complication related to pregnancy or an adverse outcome for the child, including general statements of safety. The list of commonly used medications ( n = 127, Appendix A), which included both prescription and OTC medications, was compiled using recent data from the PRegnancy and Infant DEvelopment (PRIDE) Study . We used both the generic and the brand name of the medications.…”

“…The list of commonly used medications (n = 127, Appendix A), which included both prescription and OTC medications, was compiled using recent data from the PRegnancy and Infant DEvelopment (PRIDE) Study. 20 What is already known about this subject • Most pregnant women use the Internet to search for information on pharmacological treatment.…”

Comparison of electronic self‐reported prescription medication use during pregnancy with the national prescription register in Denmark

“…Overall the results in our study comparing questionnaire reports to a PR is in line with previous findings in studies with data collection from interviews during pregnancy. Such studies find women report medicines for chronic conditions well but are less likely to report medicines for short term conditions compared to a PR or similar …”