A descriptive analysis of calls to the NSW Teratogen Information Service regarding use of anti-infectives during pregnancy.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2022
Historique:
received: 20 06 2022
accepted: 16 09 2022
entrez: 6 10 2022
pubmed: 7 10 2022
medline: 12 10 2022
Statut: epublish

Résumé

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 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. 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) to 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 were 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.

Sections du résumé

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 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) to 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 were 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.

Identifiants

pubmed: 36201464
doi: 10.1371/journal.pone.0270940
pii: PONE-D-22-17351
pmc: PMC9536608
doi:

Substances chimiques

Anti-Bacterial Agents 0
Antifungal Agents 0
Antiviral Agents 0
Teratogens 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0270940

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Références

Best Pract Res Clin Obstet Gynaecol. 2007 Jun;21(3):403-9
pubmed: 17512254
Aust N Z J Obstet Gynaecol. 2009 Apr;49(2):168-72
pubmed: 19432605
PLoS One. 2018 May 9;13(5):e0195101
pubmed: 29742159
Patient Educ Couns. 2014 Aug;96(2):171-8
pubmed: 24862909
Reprod Toxicol. 1997 Jul-Aug;11(4):633-40
pubmed: 9241686
BMJ Open. 2013 Apr 26;3(4):
pubmed: 23624989
Clin Ther. 2012 Jan;34(1):239-249.e2
pubmed: 22169049
Obstet Med. 2016 Sep;9(3):130-4
pubmed: 27630750
Birth Defects Res A Clin Mol Teratol. 2011 Nov;91(11):956-61
pubmed: 21948595
Patient Prefer Adherence. 2017 Dec 20;12:1-8
pubmed: 29302186
BMC Med Educ. 2004 Apr 05;4:6
pubmed: 15066201
BMJ Open. 2015 Jun 01;5(6):e007390
pubmed: 26033946
Clin Ther. 2016 May;38(5):1102-8
pubmed: 26973297
Am J Obstet Gynecol. 2004 Aug;191(2):398-407
pubmed: 15343213

Auteurs

Helen E Ritchie (HE)

School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Elizabeth Hegedus (E)

School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Joanne Ma (J)

School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.

Debra Kennedy (D)

Mothersafe, The Royal Hospital for Women, Sydney, New South Wales, Australia.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH