GPs’ awareness of pregnancy: trends and association with hazardous medication use

The British journal of general practice: the journal of the Royal College of General Practitioners

article

Eline Houben¹  Karin MA Swart²  Eric AP Steegers³  Petra JM Elders⁴  Ron MC Herings⁵ 

[1] PHARMO Institute for Drug Outcomes Research, Utrecht, Department of Obstetrics and Gynaecology;PHARMO Institute for Drug Outcomes Research;Department of Obstetrics and Gynaecology;Department of General Practice, Amsterdam UMC, Location Vrije Universiteit, Amsterdam Public Health Research Institute;PHARMO Institute for Drug Outcomes Research, Utrecht, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute

关键词: awareness;    electronic health records;    general practice;    inappropriate prescribing;    pregnancy;    prescriptions;   

DOI  :  10.3399/BJGP.2022.0193

学科分类：卫生学

来源: Royal College of General Practitioners

【 摘 要 】

Background GPs have been shown to be important providers of medical care during pregnancy, however, little evidence exists on their awareness of pregnancy when prescribing medication to women.Aim To assess GPs’ awareness of pregnancy and its association with prescribing medication with potential safety risks.Design and setting Population-based study using confirmed pregnancy records linked to GP records from the PHARMO Perinatal Research Network.Method GPs’ awareness of pregnancy, defined as the presence of a pregnancy confirmation in the GP information system during pregnancy, was assessed from 2004 to 2020. GP prescriptions of medication with potential safety risks were selected during pregnancy and its association with GPs’ awareness of pregnancy was assessed using multivariable logistic regression.Results A pregnancy confirmation was present in the GP records for 48% (n = 67 496/140 976) of selected pregnancies, increasing from 28% (n = 34/121) in 2004 to 63% in 2020 (n = 5763/9124). During 3% (n = 4489/140 976) of all pregnancies, the GP prescribed highly hazardous medication with teratogenic effects that should have been (temporarily) avoided. Pregnancy was GP confirmed for only 13% (n = 585/4489) at the first occurrence of such a prescription. Comparative analyses showed that women without a pregnancy confirmation were 59% more likely to be prescribed this highly hazardous medication (odds ratio [OR] 1.59, 95% confidence interval [CI] = 1.49 to 1.70) compared with those with a confirmed pregnancy.Conclusion Results of this study indicate a potential issue with GP awareness about pregnancy status at the time medication with potential safety risks is prescribed. Although pregnancy registration by GPs improved over the years, inadequate use still seems to be made of the available information systems for appropriate drug surveillance.

【 授权许可】

Free