Patterns and Factors Associated With Low Adherence to Psychotropic Medications During Pregnancy-a Cross-Sectional, Multinational Web-Based Study

Lupattelli, Angela; Spigset, Olav; Björnsdóttir, Ingunn; Hämeen‐Anttila, Katri; Mårdby, Ann-Charlotte; Panchaud, Alice; Juraški, Romana Gjergja; Rudolf, G. de M.; Odalović, Marina; Drozd, Mariola; Twigg, Michael; Juch, Herbert; Moretti, Myla E; Kennedy, Debra; Rieutord, André; Zagorodnikova, K. A.; Passier, Anneke; Nordeng, Hedvig

doi:10.1002/da.22352

Cited by 49 publications

(38 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Second, it is unknown to which degree patients were adherent to the prescribed medication; a challenge that not least could be of relevance during pregnancy 26, 27, 28. In particular, for the drugs with low number of observations in our study, the results could be vulnerable to variations caused by variable adherence in single subjects.…”

Section: Discussionmentioning

confidence: 89%

Treatment With Antipsychotics in Pregnancy: Changes in Drug Disposition

Westin

Brekke

Molden

et al. 2017

Clin Pharma and Therapeutics

Self Cite

View full text Add to dashboard Cite

Although pregnancy is known to cause changes in drug pharmacokinetics, little is known about its impact on serum levels of antipsychotics. In this study we retrospectively assessed 201 routine serum antipsychotic therapeutic drug monitoring concentration measurements obtained from a total of 110 pregnancies in 103 women, and 512 measurements from the same women before and after pregnancy. Serum concentrations in the third trimester were significantly lower than baseline for quetiapine (−76%; confidence interval (CI), −83%, −66%; P < 0.001) and aripiprazole (−52%; CI, −62%, −39%; P < 0.001), but not for olanzapine (−9%; CI, −28%, +14%; P = 0.40). For the remaining antipsychotics (perphenazine, haloperidol, ziprasidone, risperidone, and clozapine), our dataset was limited, but it indicates that concentrations may decline at least for perphenazine and possibly also for haloperidol. Even though the clinical consequence of the serum concentrations decline remains to be elucidated, our results warrant close clinical monitoring throughout pregnancy, preferentially supported by therapeutic drug monitoring.

show abstract

Section: Discussionmentioning

confidence: 89%

Treatment With Antipsychotics in Pregnancy: Changes in Drug Disposition

Westin

Brekke

Molden

et al. 2017

Clin Pharma and Therapeutics

Self Cite

View full text Add to dashboard Cite

show abstract

“…Furthermore, while the records indicate that a medication prescription was filled, we cannot estimate adherence. Previous estimates of antidepressant adherence during pregnancy are conflicting; the proportion of pregnant women estimated to have low adherence ranges from 13 to 47% (Bosman et al, ; Lupattelli et al, ). In addition, our enrollment criteria may have further impacted the generalizability of our results.…”

Section: Discussionmentioning

confidence: 99%

Using insurance claims data to identify and estimate critical periods in pregnancy: An application to antidepressants

Ailes

Simeone

Dawson

et al. 2016

Birth Defects Research

View full text Add to dashboard Cite

Background Health insurance claims are a rich data source to examine medication use in pregnancy. Our objective was to identify pregnant women, their pregnancy outcomes, and date of their last menstrual period (LMP), and to estimate antidepressant dispensations in pregnancy. Methods From a literature search, we identified diagnosis and procedure codes indicating the end of a pregnancy. Using Truven Health MarketScan® Commercial Claims and Encounters Databases, we identified all inpatient admissions and outpatient service claims with these codes. We developed an algorithm to assign: (1) pregnancy outcome (ectopic pregnancy, induced or spontaneous abortion, live birth, or stillbirth), and (2) estimated gestational age, to each inpatient or outpatient visit. For each pregnancy outcome, we estimated the LMP as the admission (for inpatient visits) or service (for outpatient visits) date minus the gestational age. To differentiate visits associated with separate pregnancies, we required ≥ 2 months between one pregnancy outcomes and the LMP of the next pregnancy. We used this algorithm to identify pregnancies in 2013 and to estimate the proportion of women who filled a prescription for an antidepressant from an outpatient pharmacy at various time points in pregnancy. Results We identified 488,887 pregnancies in 2013; 79% resulted in a live birth. A prescription for an antidepressant was filled in 6.2% of pregnancies. Dispensations varied throughout pregnancy and were lowest (3.1%) during the second trimester. Conclusion This work will inform future efforts to estimate medication dispensations during critical periods of preconception, interconception, and pregnancy using health insurance claims data.

show abstract

“…69,70 Approximately 10%-15% of pregnant women will experience depression and/or anxiety symptoms, with a high rate of relapse with discontinuation of pharmacotherapy during pregnancy. 71,72 Maternal depression and anxiety have been correlated with spontaneous preterm delivery, cesarean delivery, as well as long-term maternal and neonatal well-being. [73][74][75] benzodiazepines.…”

Section: Antianxietymentioning

confidence: 99%

Psychotropic Medications in Pregnancy and the Postpartum Period

Haas

McHugh

Durst

et al. 2015

Clinical Medicine Insights: Therapeutics

View full text Add to dashboard Cite

Many pregnant women suffer from mental health conditions while pregnant. As providers and patients make decisions about risks of the conditions and treatments during pregnancy, information to populate those discussions is needed. Taking into account the physiologic changes in pregnancy, we may need to optimize medication therapy. This article reviews and summarizes some of the most common mental health conditions suffered in pregnancy: depression, bipolar disorder, anxiety, and psychosis. It further discusses the different medications used to treat them, as well as risks associated with these medications.

show abstract

Patterns and Factors Associated With Low Adherence to Psychotropic Medications During Pregnancy-a Cross-Sectional, Multinational Web-Based Study

Abstract: Approximately one of two pregnant women using psychotropic medication demonstrated low adherence in pregnancy. Life-style factors, risk perception, depressive symptoms, and individual beliefs are important factors related to adherence to psychotropic medication in pregnancy.

Cited by 49 publications

References 46 publications

Treatment With Antipsychotics in Pregnancy: Changes in Drug Disposition

Treatment With Antipsychotics in Pregnancy: Changes in Drug Disposition

Using insurance claims data to identify and estimate critical periods in pregnancy: An application to antidepressants

Psychotropic Medications in Pregnancy and the Postpartum Period

Contact Info

Product

Resources

About