Physicians’ Perception of Teratogenic Risk and Confidence in Prescribing Drugs in Pregnancy—Influence of Norwegian Drug Information Centers

Bakkebø, Tina; Widnes, Sofia Frost; Aamlid, Synnøve Stubmo; Schjøtt, Jan

doi:10.1016/j.clinthera.2016.02.018

Cited by 10 publications

(9 citation statements)

References 21 publications

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“…As pregnant women are excluded from drug clinical trials and the extrapolation of animal data to humans is complex, HCPs need to carefully weigh the risks and benefits based on available knowledge prior to prescribing, dispensing, or administering of medications. Overestimation of risks is not limited to pregnant women as HCPs also perceive increased risks, possibly due to scientific uncertainty and underuse of specialized resources [13]. The role of TIS such as MotherSafe have been instrumental in increasing confidence in prescribing and reducing overestimated teratogenic risks among HCPs [13, 14] potentially leading to better patient outcomes [15].…”

Section: Discussionmentioning

confidence: 99%

A Descriptive Analysis of Calls to the NSW Teratogen Information Service regarding use of anti-infectives during pregnancy

Ritchie

Hegedus

et al. 2022

Preprint

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Background: MotherSafe is a free telephone-based counseling service for Australian consumers and health care providers concerned about drug exposures during pregnancy and breastfeeding. Anti-infectives are the most commonly prescribed drugs for pregnant women. This study aims to provide a retrospective, descriptive analysis of prospectively collected calls received by MotherSafe regarding anti-infective exposures during pregnancy between 2000 and 2020. Aggregate data were examined by type of caller, reason for call, pregnancy category and exposure type. Inductive thematic analysis of the comments recorded by MotherSafe counsellors at the time of call was undertaken. Results: Over the study period, 25,890 calls related to exposure to anti-infectives during pregnancy (antibiotic, antiviral and antifungal medications). Calls from patients were dominated by low-risk exposures (pregnancy category A) drugs while calls from health care professionals related to drugs with limited human information (pregnancy category B3). Analysis of MotherSafe counsellor comments revealed over 200 instances of concerns relating to health care professional advice to the patient. Three themes emerged-incorrect or conflicting advice, poor counselling, and refusal to treat, prescribe or dispense. It is likely that these comments are biased to the negative as patients would not call MotherSafe if they are happy with HCP advice. However, the findings are concerning as they reveal an underlying lack of knowledge in some health care professionals which may have led to undertreatment of patients. This study reinforced the importance of Teratogen Information Services such as MotherSafe in providing counselling and clear communication of evidence-based information to guide decision-making, reducing potential emotional distress in pregnant women and optimizing maternal, pregnancy and infant outcomes.

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Section: Discussionmentioning

confidence: 99%

A Descriptive Analysis of Calls to the NSW Teratogen Information Service regarding use of anti-infectives during pregnancy

Ritchie

Hegedus

et al. 2022

Preprint

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“…5,6 We examined more specifically perception and indices o f behaviour among the recipients of answers. 20 We recruited p hysicians who consulted Norwegian DICs for advice on patientspecific drug use in pregnancy. The physicians completed questionnaires before and after receiving the advice.…”

Section: Commentmentioning

confidence: 99%

Drug information centres and their provision of decision support: The Scandinavian experience

Schjøtt

Spigset

2019

J Clin Pharm Ther

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Summary What is known and objective Appraisal of drug information centres (DICs) is mainly by word of mouth communication and surveys of overall user satisfaction. Efforts to study the impact of this type of informatics and decision support systematically are generally lacking within the healthcare system. Comment Scandinavian DICs question‐answering databases are relevant sources for identifying recurring problems in pharmacotherapy, including drug safety questions, and for re‐use of previous answers. Recent studies in this setting have shown that high‐quality answers demand easily accessible literature sources, skills in literature search and critical assessment of the retrieved documentation. Furthermore, patient‐specific advice in clinical cases presented within a requested time frame is appraised by clinicians. What is new and conclusions Effective decision support by Scandinavian DICs depends on skills among staff and technological resources. Our experience could motivate further studies investigating methods and evaluating the impact of DICs in the healthcare system.

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“…Another suggestion is a further focus on patient-specific information provided by drug information centers and teratogen information services because such services have been found to influence both therapeutic decisions in general 27,28 and regarding pregnancy. 9,29 The Norwegian RELIS database is a question-answer pair database containing anonymized queries from health care professionals. The RELIS database is freely accessible through a web site (www.relis.no).…”

Section: Physicians' Risk Perceptionmentioning

confidence: 99%

Risk perception regarding drug use in pregnancy

Widnes

Schjøtt

2017

American Journal of Obstetrics and Gynecology

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Pregnant women, but also physicians, have unrealistically high perceptions of teratogenic drug effects. This may result in suboptimal treatment of disease and even influence decisions of whether to continue pregnancy. To attain more realistic teratogenic risk perceptions, several factors that influence this issue should be considered, and these are further discussed in this Clinical Opinion. Importantly, drug use may have several benefits, both for the pregnant woman's health and to avoid negative fetal effects of untreated maternal disease. A greater focus on this aspect may act to balance risk perceptions. Furthermore, both pregnant women and physicians need access to drug information sources that provide realistic risk estimates to increase confidence in appropriate drug use and prescribing. We suggest that access to decision support and individually tailored information provided by drug information centers may contribute to this goal.

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Physicians’ Perception of Teratogenic Risk and Confidence in Prescribing Drugs in Pregnancy—Influence of Norwegian Drug Information Centers

Cited by 10 publications

References 21 publications

A Descriptive Analysis of Calls to the NSW Teratogen Information Service regarding use of anti-infectives during pregnancy

A Descriptive Analysis of Calls to the NSW Teratogen Information Service regarding use of anti-infectives during pregnancy

Drug information centres and their provision of decision support: The Scandinavian experience

Risk perception regarding drug use in pregnancy

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