Women’s Beliefs About Medicines and Adherence to Pharmacotherapy in Pregnancy: Opportunities for Community Pharmacists

Ceulemans, Michael; Lupattelli, Angela; Nordeng, Hedvig; Odalović, Marina; Twigg, Michael; Foulon, Veerle

doi:10.2174/1381612825666190321110420

Cited by 35 publications

(33 citation statements)

References 71 publications

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“…This variation in medication use during pregnancy is in line with previous studies showing percentages ranging from 62% for the treatment of chronic psychiatric disorders35 to 93% for the treatment of hypothyroidism 36. Another study showed that patient characteristics such as educational level and occupation influence pregnant women’s perceived risks of medication use 5. We also observed some differences in sociodemographic characteristics between medicated and non-medicated women, such as maternal age, marital status or having previous children.…”

Section: Discussionsupporting

confidence: 90%

“…However, adherence to chronic medication during pregnancy is low. Previous studies among pregnant women with various chronic diseases (eg, asthma, epilepsy and inflammatory bowel diseases) have shown that about 40% of these women do not adequately adhere to their medication,4 5 which challenges appropriate management of the underlying maternal disease 6. Suboptimally treated maternal chronic diseases like epilepsy, asthma, diabetes and mental disorders can have a negative impact on the mother and on the unborn child (eg, low birth weight, macrosomia, preterm birth or perinatal mortality) 7–11.…”

Section: Introductionmentioning

confidence: 99%

“…An example is the health belief model in which beliefs are associated with behaviours 12. Previous studies have shown that patients’ medication beliefs are an important factor that can influence treatment adherence 5 13–15. These beliefs and their association with adherence may differ across diseases 16.…”

Section: Introductionmentioning

confidence: 99%

“…A newly published literature review concluded that women were more reluctant to use medication during pregnancy and that they tend to overestimate the teratogenic risk of medications. The perceived risk is influenced by different factors including the type of medication 5. Currently, little is known about pregnant women’s medication beliefs and its association with medication use during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Differences in medication beliefs between pregnant women using medication, or not, for chronic diseases: a cross-sectional, multinational, web-based study

et al. 2020

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ObjectivesTo assess whether medication beliefs differ between women who use or not use medication for their somatic chronic diseases during pregnancy and whether this association varies across diseases.DesignCross-sectional web-based survey.SettingMultinational study in Europe.ParticipantsPregnant women or women with children less than 1 year old from European countries and with asthma, allergy, cardiovascular, rheumatic diseases, diabetes, epilepsy and/or inflammatory bowel diseases (IBD).Primary and secondary outcome measureDifferences in scores of theBeliefs about Medicines Questionnaire(BMQ).ResultsIn total, 1219 women were included (ranging from 736 for allergy to 49 for IBD). Women using medication for their chronic disease (n=770; 63%) had higher scores on the BMQ subscalesnecessity(16.6 vs 12.1, p<0.001) andbenefits(16.2 vs 15.4, p<0.001), and lower values on the subscalesoveruse(12.5 vs 13.1; p=0.005) andharm(9.8 vs 10.7, p<0.001) than women not using medication. No significant differences were shown for theconcernssubscale (12.5 vs 12.3, p=0.484). Beliefs varied somewhat across diseases but in general more positive beliefs among women using medication were shown. Epilepsy was the disease where less differences were observed between women using and not using medication.ConclusionWomen’s beliefs were associated with medication use during pregnancy with only small differences across the diseases. Knowing pregnant women’s beliefs could help identify women who are reluctant to use medication and could guide counselling to support making well-informed treatment decisions.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Differences in medication beliefs between pregnant women using medication, or not, for chronic diseases: a cross-sectional, multinational, web-based study

et al. 2020

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“…Previous studies have already shown that women indeed have a higher threshold to use medicines during pregnancy compared with non‐pregnant situations and preferably avoid or delay their use . This medication hesitancy can lead to poor adherence and inadequate use of essential treatment, thereby potentially compromising foeto‐maternal outcomes . Women also tend to overestimate the teratogenic risk of medicines and substances .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and characteristics of pregnancy‐ and lactation‐related calls to the National Poison Centre in Belgium: A retrospective analysis of calls from 2012 to 2017

Ceulemans

Fortuin

Calsteren

et al. 2019

Evaluation Clinical Practice

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Rationale, aims, and objective: In the absence of a Teratology Information Service in Belgium, the National Poison Centre might act as a substitute centre for answering pregnancy-and lactation-related questions regarding medication use. The aim of this study was to define the prevalence and characteristics of pregnancy-and lactationrelated calls to the National Poison Centre in Belgium, as well as the type of health products involved during these calls.Method: A retrospective, descriptive study on pregnancy-and lactation-related calls involving health products received by the Belgian Poison Centre between January 2012 and December 2017 was performed. Health products were categorized as registered medicines or non-registered health products; medicines were further classified according to the Anatomical Therapeutic Chemical classification system. Results:The Poison Centre annually received about 361 calls related to pregnancy and lactation. Pregnant and lactating women mainly called the Poison Centre themselves in case of exposure, while relatives were the predominant type of caller when preventive information was requested. The Poison Centre was mostly contacted for information about medicines and especially for preventive questions during lactation.Many questions involved over-the-counter medicines such as paracetamol and ibuprofen. Given the safety issues related to some involved products (eg, ibuprofen, zolpidem, benzodiazepines, and pseudoephedrine), seeking for advice was justified. Conclusions:The Belgian Poison Centre received almost daily calls from patients and health care professionals on medication exposure during pregnancy and lactation.These findings underline the importance of evidence-based counselling of pregnant and lactating women and should encourage health care professionals to engage themselves more actively when counselling on the rational use of medicines during pregnancy and lactation. The findings also contribute to the ongoing discussion to establish a Teratology Information Service in Belgium.

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Risk management of teratogenic medicines: A systematic review

Shroukh

Steinke

Willis

2020

Birth Defects Research

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Aim: To systematically identify studies of implementing risk management measures when prescribing teratogenic medicines for women of childbearing age and studies reporting risk perceptions of teratogenic medications. Methods: MEDLINE, CINAHL, Scopus, EMBASE, and International Pharmaceutical Abstracts were searched. Studies were included in the risk management section if they reported any of the following risk management measures: teratogenic counseling, contraceptive counseling, pregnancy testing before starting treatment, pregnancy testing during treatment, use of contraception before starting treatment, and use of contraception during treatment. Studies were included in the perceptions section if they reported perceived teratogenic risk as numerical value. Results: Fifty-five studies were included in the risk management section and seven studies were included in the perceptions sections. Prevalence of risk management measures varied as follows: teratogenic counseling (9.5%-99.3%), contraceptive counseling (6.1%-98%), pregnancy testing before starting treatment (0%-95.1%), pregnancy testing during treatment (12.7%-100%), contraception use before starting treatment (15.7%-94%), and contraception use during treatment (1.7%-100%). A proper estimation of the teratogenic risk was reported for thalidomide (by general practitioners and obstetric/gynecologists), for etretinate (by pregnant women), and for misoprostol (by pregnant and nonpregnant women). An underestimation was reported for warfarin and retinoids (by general practitioners and obstetric/gynecologists). And overestimation was reported for thalidomide, valproate, lithium, isotretinoin, phenytoin, warfarin and etretinate by different populations. Conclusion: Considerable variation in the implementation of risk management measures when prescribing teratogenic medicines to women of childbearing age is reported in the literature. A common tendency to overestimate the risk of teratogenic medications was evident.

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Women’s Beliefs About Medicines and Adherence to Pharmacotherapy in Pregnancy: Opportunities for Community Pharmacists

Cited by 35 publications

References 71 publications

Differences in medication beliefs between pregnant women using medication, or not, for chronic diseases: a cross-sectional, multinational, web-based study

Differences in medication beliefs between pregnant women using medication, or not, for chronic diseases: a cross-sectional, multinational, web-based study

Prevalence and characteristics of pregnancy‐ and lactation‐related calls to the National Poison Centre in Belgium: A retrospective analysis of calls from 2012 to 2017

Risk management of teratogenic medicines: A systematic review

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