Risk Of Medication Use Research Articles

Assessment of Women's Knowledge about the Risks of Medication Use During Pregnancy in Al - Najaf Provence

Objective: The current study aims to assess women's knowledge about the Risks of Medication Use during Pregnancy and determine the relationship between Women's Knowledge about the Risks of Medication Use during Pregnancy and demographic characteristics. Methodology: A descriptive design /cross sectional study was conducted using analytical utilities to accomplish the stated objectives. In the time frame of 1st November 2023 to 19th July 2024. A non-probability sampling (Purposive sample) approach was used, based on the following criteria: pregnant women in any stage of the pregnancy, including the first, second, and third trimesters (primi gravida and multigravida). A sample of 250 pregnant women was chosen from those admitted to Al-Zahraa Maternity Teaching Hospital/ Al-Furat Teaching Hospital/ AL-Hakim Teaching hospital / primary Health care centers (Maternal, child, and infant care units). Results: the results show the level of knowledge differs significantly (P<0.05) according to level of education in which women who have institute and above exhibited the highest level of knowledge (MS=2.05). On the other hand, women whose husbands work in free jobs showed the highest level of knowledge (MS=1.97) while those whose husbands are retired exhibited the lowest level of knowledge (MS=1.50). Regarding gestational age, pregnant women within the (18-22) weeks exhibited the highest knowledge (MS=2.03). Conclusion: The study found that Women knew very little about the possible effects of some medications on fetal development, on the other hand the participants had little awareness of the safety of anticonvulsants and medications for the common cold and flu. Women had moderate levels of knowledge regarding the safety of using paracetamol (acetaminophen) for pain and fever during pregnancy.

An Overview of Pharmacovigilance Practice and Management in Sub-Saharan African Countries

Most sub-Sahara African countries faced with prolonged resource deficiencies suffers specific constraints in establishing a functional and operationally-free pharmacovigilance systems platforms which should guide and in facilitate the generation of vital data to reinforce health information policies and practices. Despite the commendable efforts invested by the different stake holders within such countries to harmonize pharmacovigilance guidelines and regulations, lack of integration and the dependence on pharmacovigilance systems remain major constrains. Other identified difficulties are those associated with the problem of translating data reporting tools into multiple communicable languages, and the inadequacy of the healthcare experts who translates with the patient’s population, the pressure imposed by the short consultation time between a patient and a health practitioner. To add to this, there exist issues of community concern like the increasing use of herbal traditional products with anecdotal therapeutic evidence, low quality, self-medication practices, counterfeit and roadside drugs use, substandard medications that are readily accessible to the population. Some prolonged problems are associated with social and political instability, territorial conflicts, little or no access to drug utilization data, which makes it difficult to reliably estimate the true risks of medication use. Pharmacovigilance activities are still at its infancy due to poor and less trained health personnel, lack of budget allocation for health vigilance from the State financial attributions. In addition to the limited investment in pharmacovigilance activities, there is little collaboration between public health programmes and National Medicines Regulatory Authorities (NMRA), especially during mass drug administration for neglected tropical diseases and mass vaccinations. Frequent spontaneous report in SSA is low and this can hinder robust signal detection analyses. This paper attempts to identify the challenges of the practice of pharmacovigilance in sub-Saharan African countries and its implication in health vigilance in the community. In this paper, we review the specific challenges and areas of progress in pharmacovigilance in SSA.

Database screening as a strategy to identify endogenous candidate metabolites to probe and assess mitochondrial drug toxicity

Adverse drug reactions (ADRs) are considered an inherent risk of medication use, and some ADRs have been associated with off-target drug interactions with mitochondria. Metabolites that reflect mitochondrial function may help identify patients at risk of mitochondrial toxicity. We employed a database strategy to identify candidate mitochondrial metabolites that could be clinically useful to identify individuals at increased risk of mitochondrial-related ADRs. This led to l-carnitine being identified as the candidate mitochondrial metabolite. l-carnitine, its acetylated metabolite, acetylcarnitine and other acylcarnitines are mitochondrial biomarkers used to detect inborn errors of metabolism. We hypothesized that changes in l-carnitine disposition, induced by a “challenge test” of intravenous l-carnitine, could identify mitochondrial-related ADRs by provoking variation in l-carnitine and/or acetylcarnitine blood levels. To test this hypothesis, we induced mitochondrial drug toxicity with clofazimine (CFZ) in a mouse model. Following CFZ treatment, mice received an l-carnitine “challenge test”. CFZ-induced changes in weight were consistent with previous work and reflect CFZ-induced catabolism. l-carnitine induced differences in whole blood acetylcarnitine concentrations in a manner that was dependent on CFZ treatment. This supports the usefulness of a database strategy for the discovery of candidate metabolite biomarkers of drug toxicity and substantiates the potential of the l-carnitine “challenge test” as a “probe” to identify drug-related toxicological manifestations.

Indirect and Direct 65+ Patient Reporting of Non-Steroidal Anti-Inflammatory Drug-Induced Adverse Drug Reactions as a Source of Information on Polypharmacy and Polypharmacy-Related Risk.

Background and Objectives: Non-steroidal anti-inflammatory drugs (NSAIDs), which have anti-inflammatory and analgesic properties, are commonly used in the treatment of various, particularly frequent, as well as chronic, conditions in older patients. Due to common polypragmasia in these patients and a high risk of adverse drug reactions (ADRs) and drug interactions, pain management poses a therapeutic challenge. This study describes the importance of ADR reports in the identification of polypharmacy and the ensuing interactions. Materials and Methods: Both healthcare professionals (HPs) and non-healthcare professionals (non-HPs) reports collected in the EudraVigilance database of NSAIDs, including most commonly co-reported medications and reported reactions, were analysed and differences between HPs and non-HPs reports were identified. Results: In the analysed period and group, non-HPs reported more reactions but indicated fewer drugs as suspect or concomitant. The outcomes of our analysis indicate more HP engagement and more detailed reports of serious ADRs when compared to non-serious individual case safety reports (ICSRs) by non-HPs, which appeared more detailed. Such reactions as kidney failure and increased risk of bleeding are known adverse reactions to NSAIDs and common symptoms of their interactions, which were described in the available literature. They were much more frequently reported by HPs than by non-HPs. Non-HPs more frequently reported reactions that may have been considered less significant by HPs. Conclusions: The differences between healthcare professionals' (HPs) and non-healthcare professionals' (non-HPs) reports may result from the fact that the reports from patients and their caregivers require a professional medical diagnosis based on symptoms described by the patient or additional diagnostic tests. This means that when appropriately classified, medically verified, and statistically analysed, the data may provide new evidence for the risks of medication use or drug interactions.

Cardiorespiratory fitness and incident use of anxiolytics and antidepressants in adults. A linkage study between HUNT and the Norwegian Prescription Database

BackgroundWe investigated the association between cardiorespiratory fitness (CRF) and incident use of antidepressants or anxiolytics in the general adult population. MethodsA non-exercise prediction model was used to estimate CRF in 32,603 participants in the third wave of the Trøndelag Health Study (HUNT3; 2006–08). Data on first purchase of antidepressants and anxiolytics were obtained from the Norwegian Prescription Database. Cox regression was used to estimate hazard ratios (HRs). ResultsEach 1- metabolic equivalent of task (MET) increase in CRF was associated with 4 % reduced risk of purchasing antidepressant or anxiolytic medication during follow-up (HR 0.96, 95 % Confidence interval [CI] 0.94–0.98). Compared to the low CRF tertile, participants in intermediate (HR 0.93, 95 % CI 0.87–0.98) and high (HR 0.92, 95 % CI 0.86–0.98) CRF tertiles had reduced risk of medication purchase. Men in intermediate and high CRF tertile had lower risk of medication purchase (intermediate HR 0.87, 95 % CI 0.79–0.96; high HR 0.87, 95 % CI 0.78–0.96). Intermediate and high CRF tertiles were associated with reduced risk of medication use for younger adults (20 to <30 years old; intermediate HR 0.74, 95 % CI 0.61–0.91, high HR 0.78, 95 % CI 0.64–0.95) and middle-aged adults (30 to <65 years old; intermediate HR 0.90, 95 % CI 0.83–0.97, high HR 0.90, 95 % CI 0.84–0.98), but not in older adults (≥65 years old). LimitationsOnly information about medication purchase and not actual use was available. ConclusionIncreased CRF is associated with reduced risk of anxiolytics and antidepressants purchase, with stronger effects for men and younger adults.

Risk of spontaneous abortion after periconceptional medication use: Time to tackle the methodological challenges.

Risk of spontaneous abortion after periconceptional medication use: Time to tackle the methodological challenges.

Attitudes and Practices of Community Pharmacists toward the Risk of Medication Use by Pregnant Women: A Cross-Sectional Study in the Qassim Region, Saudi Arabia

Attitudes and Practices of Community Pharmacists toward the Risk of Medication Use by Pregnant Women: A Cross-Sectional Study in the Qassim Region, Saudi Arabia

Inflammatory Bowel Disease and Pregnancy

Inflammatory Bowel Disease and Pregnancy

Laparoscopic Nissen fundoplication versus 90° and 180° fundoplication for gastroesophageal reflux disease

Summary Background Laparoscopic Nissen fundoplication (LNF) is standard care for surgical treatment of gastroesophageal reflux disease (GERD) in adults. The main disadvantage is the compression of the food passageway, affecting the ability to belch and vomit, and causing swallowing difficulties. Therefore, partial fundoplication methods encircling esophagus as little as 90° and 180° have been developed. Previous studies have been inconclusive. The aim was to assess the effectiveness of LNF compared to laparoscopic anterior 90° and 180° fundoplication. Methods Randomized controlled trials were searched for in MEDLINE, Embase, CINAHL, the Cochrane Library, and Web of Science, and in eligible studies’ reference lists and relevant reviews. Outcomes of interest were 5-year heartburn, medication use, dysphagia, reoperation, and satisfaction. Dichotomous data were calculated as risk ratios (RR). Subgroup analyses were performed to compare each comparator separately with LNF. The meta-analyses were conducted using a random-effects model with an inverse variance statistical method and a significance level of 0.05. Results Four eligible trials were included with 398 participants, of which half compared LNF with 90°. At 5 years there was higher risk of dysphagia for solids after LNF compared to 90° and 180° fundoplication (RR 1.68 [1.14, 2.49]). However, LNF was associated with a significantly lower risk of medication use compared to laparoscopic anterior 90° fundoplication (RR 0.23 [0.09, 0.58], subgroup analysis). No differences between treatments in terms of heartburn, reoperation, and satisfaction were found. Conclusion The limited evidence fails to provide an unequivocal method of choice, but rather indicates a trade-off between reflux control and complications.

OP19 Disease course and treatment outcomes of early resected Crohn’s Disease patients: A Danish nationwide cohort study from 1997 to 2015

Abstract Background Limited resective surgery is used as a primary therapeutic option in patients with Crohn’s disease (CD) who present with severe symptoms or fibrostenotic complications. Recent studies suggest that surgery represents a valid alternative of biological therapy in subgroups of CD patients.1 However, only few studies have described the disease course in early resected CD patients regardless of disease location. This study aimed to investigate disease course in all early resected CD patients. Methods Using the Danish National Patient Registry (NPR), we identified 9739 patients who were diagnosed with CD between January 1st, 1997 and December 31st, 2015. Of those, 499 patients underwent a major abdominal surgery within 30 days before or after their diagnosis. Data on re-operation, hospitalization and medication use were retrieved from the NPR and the National Prescription Registry. Trends in treatment outcomes over time were assessed using Chi-square test, Kaplan Meier survival analysis and log-rank test. Results Overall, 217 (43.5%) patients had an initial ileocecal resection, 154 (30.9%) had a colonic resection and 112 (22.4%) had a small bowel resection and 16(3.2%) patients without classification of surgery. The cumulative risk of reoperation was 16.4% at five years after the initial surgery. Five-year risk of hospitalization and need for medical therapy was 66.1% and 61.7% (Figure 1). Among 326 (65.3%) patients who received medical therapy during follow-up, 216 (66.3%) were treated with an immunomodulator and 62 (19.0%) with a biological drug. There was no difference in the risk of re-operation (p=0.11), hospitalization (p=0.70) or medication use (p=0.37) in relation to the anatomic location of the initial surgery. When comparing patients diagnosed before and after 2005, five-year risk of hospitalization decreased from 76.9% to 56.1% (p&amp;lt;0.001, Figure 2), while five-year risk of medication use decreased from 65.9% to 58.5% (p=0.01, Figure 2). In contrast, five-year risk of re-operation showed an increasing, but insignificant trend from 13.7% to 18.6% (p=0.18). Conclusion The risk of re-operation and hospitalization after the initial surgery in this cohort of early resected CD patients are lower when compared to other CD cohorts. Furthermore, hospitalization risk and need for medical therapy decreased over time. Reference

Drugs exposures during pregnancy and neonatal risk assessment

Background: Medication use is inevitable in the management of chronic or acute disease conditions during pregnancy. However, obstetric pharmacotherapy is most challenging for healthcare providers as they make effort to balance the benefit and risk of medication use during pregnancy. Objective: To profile medical conditions and medication use during pregnancy, and to assess potential or actual neonatal risks following drug exposure in pregnancy. Methods: The study was carried out in 6 healthcare facilities in Edo State, Nigeria. A total of 2,530 pregnant women attending antenatal clinics (ANC) in the health facilities were recruited and followed-up to delivery. Demographic, clinical, obstetric, and drug information were collected from women during their first encounter with the investigator and these data were updated in subsequent follow-up visits by the women. Data were collected through interviews, review of medical records and ANC cards. At delivery, the clinical information of the neonates was obtained and recorded and neonatal risk assessment undertaken. The prescribed medications were classified as safe, low risk and high risk drugs in pregnancy. Paired sample t-test method was used to copmpared categorical veriables and p-values

What do older adults with multimorbidity and polypharmacy think about deprescribing? The LESS study - a primary care-based survey

BackgroundMultimorbidity and polypharmacy are very common in older adults in primary care. Ideally, general practitioners (GPs), should regularly review medication lists to identify inappropriate medication(s) and, where appropriate, deprescribe. However, it remains challenging to deprescribe given time constraints and few recommendations from guidelines. Further, patient related barriers and enablers to deprescribing have to be accounted for. The aim of this study was to identify barriers and enablers to deprescribing as reported by older adults with polypharmacy and multimorbidity.MethodsWe conducted a survey among participants aged ≥70 years, with multimorbidity (≥3 chronic conditions) and polypharmacy (≥5 chronic medications). We invited Swiss GPs, to recruit eligible patients who then completed a paper-based survey on demographics, medications and chronic conditions. We used the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire and added twelve additional Likert scale questions and two open-ended questions to assess barriers and enablers towards deprescribing, which we coded and categorized into meaningful themes.ResultSixty four Swiss GPs consented to recruit 5–6 patients each and returned 300 participant responses. Participants were 79.1 years (SD 5.7), 47% female, 34% lived alone, and 86% managed their medications themselves. Sixty-seven percent of participants took 5–9 regular medicines and 24% took ≥10 medicines. The majority of participants (77%) were willing to deprescribe one or more of their medicines if their doctor said it was possible. There was no association with sex, age or the number of medicines and willingness to deprescribe. After adjustment for baseline characteristics, there was a strong positive association between willingness to deprescribe and saying that because they have a good relationship with their GP, they would feel that deprescribing was safe OR 11.3 (95% CI: 4.64–27.3) and agreeing that they would be willing to deprescribe if new studies showed an avoidable risk OR 8.0 (95% CI 3.79–16.9). From the open questions, the most mentioned barriers towards deprescribing were patients feeling well on their current medicines and being convinced that they need all their medicines.ConclusionsMost older adults with polypharmacy are willing to deprescribe. GPs may be able to increase deprescribing by building trust with their patients and communicating evidence about the risks of medication use.

PIH13 Medications Risk and Pregnancy: Knowledge, Attitude, and Practice of Pharmacists in Gondar TOWN, North WEST Ethiopia. a CROSS-Sectional Study

:The aim of this study was to assess the knowledge, attitude, and practice of pharmacy professionals toward the risk of medication use during pregnancy in Gondar town. A questionnaire-based cross-sectional survey was carried out over practicing community and hospital pharmacists in Gondar town. Both descriptive and analytic statistics was utilized. For descriptive analysis, results were expressed as numbers, percentages and mean (± SD and 95% CI). Out of 152 pharmacists invited to participate, 135 of them completed the survey giving a response rate of 88.8%.The mean age of respondents was 28.64 years with a standard deviation of ± 5.0. Moreover, the majority of pharmacists 78 (57.8%) had >5years and 57 (42.2%) had <5years of work experience. About 74 (54.8%) of the respondent knew the harmful effect of medication use during pregnancy and two-third of the participants (60%) knew the cause of NSAIDs when it used in the third trimester. More than half of the participants 75 (55.6%) agreed that most of the presently available drugs are unsafe during pregnancy and among the respondent, about 65(48%) of the respondent was believed that drugs increase the risk of birth defects to a very large extent. The majority of the respondent (72%) also reported they tell a common side effect to pregnant women. Most respondents exhibited a healthy attitude and practice but very low knowledge about drug safety during pregnancy. Even if the pharmacists exhibit a healthy attitude towards medication use during pregnancy, there are still gaps in knowledge where educational interventions are needed.

A model for human and animal data integration: Weight of evidence strategy.

Integration of animal and human data to assess potential risks of the use of medications in pregnancy is important. A qualitative weight of evidence process enables all available evidence to be considered in a consistent, systematic manner. We aim to describe the weight of evidence methodology utilized by the authors, a summary of which was presented at the 59th Annual Meeting of the Teratology Society entitled "Integration of Human and Animal Data to Inform Medication Use in Pregnant Women." The qualitative weight of evidence process evaluates data that inform on a potential relationship between an adverse pregnancy outcome and a medication exposure. An interdisciplinary panel evaluates all available human and animal data related to the question of interest. Study quality assessments of both human and animal data are incorporated. The evaluation assesses gaps in the data from the following areas: (a) strength, (b) specificity, (c) consistency, (d) dose response relationship, (e) methodological considerations, and (f) biological plausibility for the potential association of interest. The panel integrates all the information to arrive at an assessment of the evidence and provides recommendations, which may include obtaining more specific information. We provide examples of how the authors apply this process at a pharmaceutical company for evaluation of potential postmarketing safety issues regarding medications and pregnancy outcomes. This weight of evidence method improves the ability to integrate published literature and other data sources to assess the potential risks of medication use in pregnant women and inform future drug safety studies.

PIH60 MEDICATIONS RISK AND PREGNANCY: KNOWLEDGE, ATTITUDE, AND PRACTICE OF PHARMACISTS IN GONDAR TOWN, NORTH WEST ETHIOPIA. A CROSS-SECTIONAL STUDY

The aim of this study was to assess the knowledge, attitude, and practice of pharmacy professionals toward the risk of medication use during pregnancy in Gondar town. A questionnaire-based cross-sectional survey was carried out over practicing community and hospital pharmacists in Gondar town. Both descriptive and analytic statistics was utilized. For descriptive analysis, results were expressed as numbers, percentages and mean (± SD and 95% CI). Out of 152 pharmacists invited to participate, 135 of them completed the survey giving a response rate of 88.8%.The mean age of respondents was 28.64 years with a standard deviation of ± 5.0. Moreover, the majority of pharmacists 78 (57.8%) had >5years and 57 (42.2%) had <5years of work experience. About 74 (54.8%) of the respondent knew the harmful effect of medication use during pregnancy and two-third of the participants (60%) knew the cause of NSAIDs when it used in the third trimester. More than half of the participants 75 (55.6%) agreed that most of the presently available drugs are unsafe during pregnancy and among the respondent, about 65(48%) of the respondent was believed that drugs increase the risk of birth defects to a very large extent. The majority of the respondent (72%) also reported they tell a common side effect to pregnant women. Most respondents exhibited a healthy attitude and practice but very low knowledge about drug safety during pregnancy. Even if the pharmacists exhibit a healthy attitude towards medication use during pregnancy, there are still gaps in knowledge where educational interventions are needed.

Safety of medication use during pregnancy in mainland China: based on a national health insurance database in 2015

BackgroundMedication safety during pregnancy has drawn global attention, little of which has been reported about the Chinese population. This study aims to describe patterns and risks of medication use among pregnant women in mainland China with reference to the U.S. Food and Drug Administration (FDA) pregnancy risk category.MethodsHospital diagnostic and drug dispensing information of a national representative sample of basic medical insurance (BMI) beneficiaries was obtained from the China Health Insurance Association (CHIRA) database in 2015. Prevalence of use and number of medicines involved in each risk category were calculated. Most commonly used medicines from each risk category were illustrated. Factors associated with the use of category D/X medicines were evaluated through multiple logistic regression.ResultsOut of 11,373 women who had singleton deliveries in 2015, there were 2896 women with records covering their entire pregnancies, 5377, and 7946 women with records through the 2nd, and the 3rd trimester, respectively. It was found that 11.1% pregnant women used at least one medication and a total of 321 medications had been used during pregnancy. Most pregnant women used medicines which were classified FDA category C (66.2%), followed by category B (57.8%), category A (16.8%), category X (7.5%) and category D (5.0%). The most commonly used medicines from category D and X were anxiolytics and hormonal preparations respectively. Women who were from mid-western area (p = 0.045) or used four or more medications (p < 0.001) were more likely to use category D/X medicines.ConclusionsThis study revealed that about one in ten pregnant women used at least one medication during pregnancy in China and a significant number of them used FDA Category D or X medicines. The usage patterns identified in the present study indicate that sub-optimal medicine use might exist warranting further evaluation and intervention in future studies. More efforts are needed to uncover the safety concerns about medication use during pregnancy and improve current information system for clinical practice.

Evaluation of Knowledge and Practice of Pharmacy Professionals regarding the Risk of Medication Use during Pregnancy in Dessie Town, Northeast Ethiopia: A Cross-Sectional Study.

Background The developing organism is unique in its responsiveness to drugs and predictability of therapeutic effectiveness based on the adult which can lead to grave consequences in the neonate and child. Moreover, uncertainty about the risks of drug use in pregnancy could result in restrictive attitudes towards prescribing and dispensing medicines and their use. Pharmacists have huge duties to improve medication use, especially among pregnant women. The objective of this study is, hence, to assess the knowledge and practice of pharmacy professionals (PPs) towards the risk of medication use during pregnancy. Methodology A questionnaire-based cross-sectional study was carried out over practicing community and hospital pharmacy professionals in Dessie town. They were asked about the safety of common drugs during pregnancy. It involves both prescription-only medications (POM) and over-the-counter (OTC) medications. Secondly, they were asked about their practice towards the risk of medication use during pregnancy. Both descriptive and analytical statistics were utilized. For descriptive analysis, results were expressed as numbers, percentages, and mean (± SD and 95% CI). Result Seventy-six pharmacy professionals in Dessie, Northeast Ethiopia, took part in the study. Most of the respondents (64.5%) believed that amoxicillin is safe in all trimesters. 26 (34.2%) of participants knew that isotretinoin is unsafe for use by pregnant women. About dietary supplements, 32.9% of PPs reported that Vitamin A supplements are safe in all trimesters. There was a significant difference observed for study college and years of experience of the PPs in their score of knowledge test (p=0.020 and p=0.024, respectively). Additionally, there was a difference seen for gender (p=0.030), study college (p=0.036), and working institution (p=0.013) in their advice to pregnant women. Conclusion and Recommendation Overall, PPs exhibited very low knowledge about drug safety during pregnancy. The absence of obligatory continuing pharmacy education for pharmacists is expected to have negatively affected the level of medication knowledge and consequently the pharmaceutical care services delivered in community and hospital pharmacies. As medication knowledge of PPs is poor, a multitude of strategies (educational, economic, managerial, and regulatory) should be designed by the government, universities, and pharmaceutical associations to improve the pharmacy professionals' role in the healthcare system by providing them with continuous and up-to-date medication knowledge.

A practical guide to the use of psychotropic medications during pregnancy and lactation

The use of psychotropic medications during the perinatal period is often met with fear and discomfort on the part of both clinicians and patients. There is a great deal of misinformation about the risks of medication use during pregnancy and lactation. The risk of untreated or undertreated mental illness during this time is an important consideration when making treatment recommendations. This paper serves as a practical guide for clinicians who may be treating patients with psychotropic medication during the perinatal period. A heuristic tool for making treatment decisions will be introduced, and coverage of specific psychiatric disorders and medication classes will be provided.

Improving Safe Use of Medications During Pregnancy: The Roles of Patients, Physicians, and Pharmacists.

Our study sought to explore the actual and potential roles of patients, physicians, and pharmacists, as well as their shared challenges and opportunities, in improving the safety of medication use during pregnancy. We conducted virtual focus groups with 48 women and in-depth interviews with nine physicians and five pharmacists. Qualitative analysis revealed that all three groups of participants reported "playing it safe," the need for an engaged patient making informed decisions, challenges surrounding communication about pregnancy status, and a lack of patient-centric resources. Patients, physicians, and pharmacists are highly motivated to protect developing babies from potential harms of medication use during pregnancy while maintaining the patient's health. Strategic messaging could maximize the effectiveness of these interactions by helping physicians discuss the benefits and risks of medication use during pregnancy, pharmacists screen for pregnancy and counsel on medication safety, and patients using medications to share pregnancy intentions with their providers pre-pregnancy.

Knowledge of community pharmacists about the risks of medication use during pregnancy in central region of Saudi Arabia

BackgroundCommunity pharmacists (CPs) are the most accessible health care provider to the public, and they have huge duties to improve medication use especially among the pregnant women in their community. The objective of this study was to evaluate knowledge of CPs about the medication safety during pregnancy. MethodsA prospective cross-sectional survey was carried out over practicing community pharmacists in a capital of Saudi Arabia (SA). Pharmacists were asked about the safety of each medicine during pregnancy. It involved both prescription-only medications (POM) and over-the-counter (OTC) medications. Both descriptive and analytic statistics were utilized. For descriptive analysis, results were expressed as numbers, percentages and mean (±SD and 95% CI). ResultsThe response rate was (71.1%). Most of the respondents (69.6%) believed that alprazolam is not safe while 22% of respondents believed that it is used on basis of risk-benefit assessment. Also, most of CPs (65.2%) said that amoxicillin is safe, but a very few of CPs (11.7%) knew that tetracycline should be used only if potential benefits may outweigh the risk. Among non-prescribed analgesics, majority of CPs (92.6%) knew that acetaminophen is safe. About dietary supplements, 48.4% of CPs reported that Vitamin A supplements are not safe. There was significant difference observed between age groups of CPs in scores of knowledge test (P=0.001). ConclusionCommunity Pharmacists are the most accessible health care providers who can help pregnant women with their medications use there are still gaps in knowledge where educational interventions are needed.