Drug information in pregnancy. Attitudes and needs among pregnant women and physicians

Abstract

Background: Drug use in pregnancy is common and both pregnant women and their physicians are in need of appropriate information for decision-making regarding drug therapy. However, uncertainty about the risks of drug use in pregnancy could result in restrictive attitudes to prescribing medicines and to their use. Purpose: To examine attitudes of and needs for medicines information among pregnant women and physicians. Materials and methods: Four studies based on three different methods were included; I: a descriptive study comparing drug advice regarding pregnancy from two commonly used sources: the Norwegian Drug Information Centres (DICs, named RELIS) and the product monographs in Felleskatalogen (FK), II: a survey among physicians who consulted RELIS for information on patient-specific drug use during pregnancy, III: interviews of pregnant women with epilepsy (WWE) using antiepileptic drugs (AEDs), IV: a survey among women attending ultrasound examination in gestation weeks 17-19 and their respective general practitioners (GPs). Results: Commonly used sources of information differed in advice regarding drug use in pregnancy. RELIS was a valued service among physicians and most advice had a clinical impact on therapeutic decisions. Pregnant WWE were confident in using AEDs through communication with their neurologist, but were concerned about dose adjustments. Pregnant women had higher teratogenic risk perceptions and lower confidence in use of medicines compared to their GPs. Phrasing of information texts may have influenced teratogenic risk perceptions. Conclusions and further implications: Deciding whether or not to prescribe or use medicines in pregnancy may be influenced by teratogenic risk perceptions, phrasing of medicines information, differences in advice between sources of information and availability of patient-specific and producer-independent medicines information. Physicians should aim to tailor the information to the pregnant woman’s risk perception level and desire for information.