Knowledge, Information Sources, and Institutional Trust of Patients Regarding Medication Use in Pregnancy: A Systematic Review
-
Abirami Kirubarajan
,
Andrew Lam
,
Amy Yu
,
Cameron Taheri
,
Shawn Khan
,
Claire Sethuram
,
Vikita Mehta
,
Nancy Olivieri
Abstract
Objective: The objective of our study is to characterize the knowledge, information sources, and institutional trust of patients regarding medication use in pregnancy.
Materials and methods: We conducted a review of three databases: MEDLINE, EMBASE, and CINAHL. We included observational studies and knowledge assessments that examined the knowledge, attitudes, beliefs or information sources of pregnant patients related to medication use during pregnancy. Extraction was completed by two independent reviewers, outcomes were summarized descriptively, and appraisal was conducted.
Results: Of the 1359 search results, 34 studies met inclusion criteria. Thus, our systematic review encompasses the beliefs of 11,757 pregnant participants. In most studies, participants described apprehension regarding potential risks to the fetus and the inadequacy of safety information. Across the 23 knowledge assessments, the majority of studies reported patient misconceptions about prescription medication in pregnancy. The most preferred information source was a healthcare provider. However, many participants expressed frustration, mistrust, and skepticism regarding physician knowledge. A common source of mistrust was due to perceived physician self-interest as well as a lack of education tailored to pregnancy. Consequently, informal sources of information were also popular.
Conclusion: There is a need to improve the health literacy and trust among pregnant patients regarding drug prescribing. There are modifiable risk factors for mistrust that require further attention.
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32. Kureshee NI, Dhande PP. Awareness of mothers and doctors about drug utilization pattern for illnesses encountered during pregnancy. J Clin Diagn Res 2013; 7: 2470-4.
33. Pons Eda S, Pizzol Tda S, Knauth DR. Perceptions by pregnant and childbearing-age women in southern Brazil towards teratogenic risk from medicines and
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35. Zaki NM, Albarraq AA. Use, attitudes and knowledge of medications among pregnant people: A Saudi study. Saudi Pharm J 2014; 22: 419-28.
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40. Abduelkarem AR, Mustafa H. Use of over-the-counter medication among pregnant people in Sharjah, United Arab Emirates. J Pregnancy 2017; 2017: 4503793.
41. Cabut S, Marie C, Vendittelli F, Sauvant-Rochat MP. Intended and actual use of self-medication and alternative products during pregnancy by French women. J Gynecol Obstet Hum Reprod 2017; 46: 167-73.
42. Devkota R, Khan GM, Alam K, Sapkota B, Devkota D. Impacts of counseling on knowledge, attitude and practice of medication use during pregnancy. BMC Pregnancy Childbirth 2017; 17: 131.
43. Raheel H, Alsakran S, Alghamdi A, Ajarem M, Alsulami S, Mahmood A. Antibiotics and over the counter medication use and its correlates among Arab pregnant people visiting a tertiary care hospital in Riyadh, Saudi Arabia. Pak J Med Sci 2017; 33: 452-6.
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2. Potts JM, Nelson-Piercy C. Prescribing in pregnancy. Obstetrics, Gynaecology & Reproductive Medicine 2013; 23: 137-45
3. Sherman LA, Temple R, Merkatz RB. Women in clinical trials: an FDA perspective. Science 1995; 269: 793-5.
4. Holdcroft A. Gender bias in research: how does it affect evidence based medicine?. J R Soc Med 2007; 100: 2-3.
5. Meinert CL, Gilpin AK. Estimation of gender bias in clinical trials. Stat Med 2001; 20: 1153-64.
6. Shields KE, Lyerly AD. Exclusion of pregnant people from industry-sponsored clinical trials. Obstet Gynecol 2013; 122: 1077-81.
7. Mazer-Amirshahi M, Samiee-Zafarghandy S, Gray G, van den Anker JN. Trends in pregnancy labeling and data quality for US-approved pharmaceuticals. Am
J Obstet Gynecol 2014; 211: 690-e1.
8. Bakkebø T, Widnes SF, Aamlid SS, Schjøtt J. Physicians’ perception of teratogenic risk and confidence in prescribing drugs in pregnancy—influence of Norwegian drug information centers. Clin Ther 2016; 38: 1102-8.
9. Baldon JP, Correr CJ, Melchiors AC, Rossignoli P, Fernandez-Llimos F, Pontarolo R. Community pharmacists’ attitudes and knowledge on dispensing drugs to pregnant people. Pharm Pract 2006; 4: 38-43.
10. Hutchinson S, Mitchell K, Hansford D, Stewart D. Community pharmacists' views and experiences of counter‐prescribing in pregnancy. Int J Pharm Pract 2001; 9: 15-21.
11. Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernández-Díaz S, et al. Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. Am J Obstet Gynecol 2011; 205: 51-e1-8.
12. Werler MM, Mitchell AA, Hernandez-Diaz S, Honein MA. Use of over-the-counter medications during pregnancy. Am J Obstet Gynecol 2005; 193: 771-7.
13. Tillett J, Kostich LM, VandeVusse L. Use of over-the-counter medications during pregnancy. J Perinat Neonatal Nurs 2003; 17: 3-18.
14. Tucker Edmonds B. Shared decision-making and decision support: their role in obstetrics and gynecology. Curr Opin Obstet Gynecol 2014; 26: 523-30.
15. Say R, Robson S, Thomson R. Helping pregnant people make better decisions: a systematic review of the benefits of patient decision aids in obstetrics. BMJ Open 2011; 1: e000261.
16. Prather C, Fuller TR, Marshall KJ, Jeffries WL. The impact of racism on the sexual and reproductive health of African American women. J Womens Health (Larchmt) 2016; 25: 664-71.
17. Grande D, Shea JA, Armstrong K. Pharmaceutical industry gifts to physicians: patient beliefs and trust in physicians and the health care system. J Gen Intern Med 2012; 27: 274-9.
18. Boucher D, Bennett C, McFarlin B, Freeze R. Staying home to give birth: why women in the United States choose home birth. J Midwifery Womens Health 2009; 54: 119-26.
19. Moher D, Liberati A, Tetzlaff J, Altman DG, Prisma Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6: e1000097.
20. Peters MD, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc 2015; 13:141-6.
21. Aviv RI, Chubb K, Lindow SW. The prevalence of maternal medication ingestion in the antenatal period. S Afr Med J 1993; 83: 657-60.
22. Henry A, Crowther C. Sources of advice on medication use in pregnancy and reasons for medication uptake and cessation during pregnancy. Aust N Z J Obstet Gynaecol 2000; 40: 173-5.
23. Sharma R, Kapoor B, Verma U. Drug utilization pattern during pregnancy in North India. Indian J Med Sci 2006; 60: 277-87.
24. Damase‐Michel C, Christaud J, Berrebi A, Lacroix I, Montastruc JL. What do pregnant people know about non‐steroidal anti‐inflammatory drugs? Pharmacoepidemiol Drug Saf 2009; 18: 1034-8.
25. Nordeng H, Koren G, Einarson A. Pregnant people's beliefs about medications-a study among 866 Norwegian women. Ann Pharmacother 2010; 44: 1478-84.
26. Nordeng H, Ystrøm E, Einarson A. Perception of risk regarding the use of medications and other exposures during pregnancy. Eur J Clin Pharmacol 2010; 66: 207-14.
27. Antolič R, Polič M, Stanovnik L, Antolič ŽN. Medication interest in pregnant people. Zdravniški vestnik 2011; 80: 897-904.
28. Kamuhabwa A, Jalal R. Drug use in pregnancy: Knowledge of drug dispensers and pregnant people in Dar es Salaam, Tanzania. Indian J Pharmacol 2011; 43: 345-9.
29. Ekama SO, Herbertson EC, Addeh EJ, Gab-Okafor CV, Onwujekwe DI, Tayo F, et al. Pattern and determinants of antiretroviral drug adherence among Nigerian pregnant people. J Pregnancy 2012; 2012: 851810.
30. Kassaw C, Wabe NT. Pregnant people and non-steroidal anti-inflammatory drugs: knowledge, perception and drug consumption pattern during pregnancy in Ethiopia. N Am J Med Sci 2012; 4: 72-6.
31. Baghianimoghadam MH, Mojahed S, Baghianimoghadam M, Yousefi N, Zolghadr R. Attitude and practice of pregnant women regarding self-medication in Yazd, Iran. Arch Iran Med 2013; 16: 580-3.
32. Kureshee NI, Dhande PP. Awareness of mothers and doctors about drug utilization pattern for illnesses encountered during pregnancy. J Clin Diagn Res 2013; 7: 2470-4.
33. Pons Eda S, Pizzol Tda S, Knauth DR. Perceptions by pregnant and childbearing-age women in southern Brazil towards teratogenic risk from medicines and
radiotherapy. Cad Saude Publica 2014; 30: 1965-76.
34. Walton GD, Ross LE, Stewart DE, Grigoriadis S, Dennis CL, Vigod S. Decisional conflict among women considering antidepressant medication use in pregnancy. Arch Womens Ment Health 2014; 17: 493-501.
35. Zaki NM, Albarraq AA. Use, attitudes and knowledge of medications among pregnant people: A Saudi study. Saudi Pharm J 2014; 22: 419-28.
36. Nörby U, Källén K, Shemeikka T, Korkmaz S, Winbladh B. Pregnant people's view on the Swedish internet resource Drugs and Birth Defects intended for health care professionals. Acta Obstet Gynecol Scand 2015; 94: 960-8.
37. Bohio R, Brohi ZP, Bohio F. Utilization of over the counter medication among pregnant people; a cross-sectional study conducted at Isra University Hospital, Hyderabad. J Pak Med Assoc 2016; 66: 68-71.
38. Juch H, Lupattelli A, Ystrom E, Verheyen S, Nordeng H. Medication adherence among pregnant people with hypothyroidism—missed opportunities to improve reproductive health? A cross-sectional, web-based study. Patient Educ Couns 2016; 99: 1699-707.
39. Sarani M, Saravani S. Knowledge, attitude and practice of self-medication among pregnant people in the city of zabol. International Journal of Pharmacy & Technology 2016; 8: 21588-99.
40. Abduelkarem AR, Mustafa H. Use of over-the-counter medication among pregnant people in Sharjah, United Arab Emirates. J Pregnancy 2017; 2017: 4503793.
41. Cabut S, Marie C, Vendittelli F, Sauvant-Rochat MP. Intended and actual use of self-medication and alternative products during pregnancy by French women. J Gynecol Obstet Hum Reprod 2017; 46: 167-73.
42. Devkota R, Khan GM, Alam K, Sapkota B, Devkota D. Impacts of counseling on knowledge, attitude and practice of medication use during pregnancy. BMC Pregnancy Childbirth 2017; 17: 131.
43. Raheel H, Alsakran S, Alghamdi A, Ajarem M, Alsulami S, Mahmood A. Antibiotics and over the counter medication use and its correlates among Arab pregnant people visiting a tertiary care hospital in Riyadh, Saudi Arabia. Pak J Med Sci 2017; 33: 452-6.
44. Byatt N, Cox L, Moore Simas TA, Biebel K, Sankaran P, Swartz HA, et al. Access to Pharmacotherapy Amongst Women with Bipolar Disorder during Pregnancy: a Preliminary Study. Psychiatr Q 2018; 89: 183-90.
45. Denton LK, Creeley CE, Stavola B, Hall K, Foltz BD. An analysis of online pregnancy message boards: Mother-to-mother advice on medication use. Women Birth 2020; 33: e48-e58.
46. Navaro M, Vezzosi L, Santagati G, Angelillo IF,
Collaborative Working Group. Knowledge, attitudes, and practice regarding medication use in pregnant people in Southern Italy. PloS One 2018; 13: e0198618.
47. Sinclair M, Lagan BM, Dolk H, McCullough JEM. An assessment of pregnant people's knowledge and use of the Internet for medication safety information and purchase. J Adv Nurs 2018; 74: 137-47.
48. Sverrisdóttir U, Jónsdóttir F, Gunnarsdóttir AI, Harðardóttir H, Bjarnadóttir RI. Use of medication, supplements and natural products during pregnancy. Laeknabladid 2019; 105: 11-6.
49. Yakuwa N, Nakajima K, Koinuma S, Goto M, Suzuki T, Ito N, et al. Perception of pregnant Japanese women regarding the teratogenic risk of medication exposure during pregnancy and the effect of counseling through the Japan drug information institute in pregnancy. Reprod Toxicol 2018; 79: 66-71.
50. Kothari A, de Laat J, Dulhunty JM, Bruxner G. Perceptions of pregnant people regarding antidepressant and anxiolytic medication use during pregnancy. Australas Psychiatry 2019; 27: 117-20.
51. Wolgast E, Lindh‐Åstrand L, Lilliecreutz C. Women's perceptions of medication use during pregnancy and breastfeeding—A Swedish cross‐sectional questionnaire study. Acta Obstet Gynecol Scand 2019; 98: 856-64.
52. Atmadani RN, Nkoka O, Yunita SL, Chen YH. Self-medication and knowledge among pregnant people attending primary healthcare services in Malang, Indonesia: a cross-sectional study. BMC Pregnancy Childbirth 2020; 20: 42.
53. Munoz SR, Lupattelli A, de Vries ST, Mol PG, Nordeng H. Differences in medication beliefs between pregnant people using medication, or not, for chronic diseases: a cross-sectional, multinational, web-based study. BMJ Open 2020; 10: e034529.
54. Searle AR, Hurley EA, Doumbia SO, Winch PJ. “They Merely Prescribe and I Merely Swallow”: Perceptions of Antenatal Pharmaceuticals and Nutritional Supplements Among Pregnant people in Bamako, Mali. Matern Child Health J 2020; 24: 110-20.
55. Araújo DD, Leal MM, Santos EJ, Leal LB. Consumption of medicines in high-risk pregnancy: evaluation of determinants related to the use of prescription drugs and self-medication. Brazilian Journal of Pharmaceutical Science 2013; 49: 491-9.
56. Parry DC. “We wanted a birth experience, not a medical experience”: exploring Canadian women's use of midwifery. Health Care Women Int 2008; 29: 784-806.
57. Shaw JC. The medicalization of birth and midwifery as resistance. Health Care Women Int 2013; 34: 522-36.
58. Ziadeh S, Yahaya A. Pregnancy outcome at age 40 and older. Arch Gynecol Obstet 2001; 265: 30-3.
59. Mills, TA, Lavender T. Advanced maternal age. Obstet Gynaecol Reprod Med 2011; 21: 107-11
60. Ferrara A, Kahn HS, Quesenberry CP, Riley C, Hedderson MM. An increase in the incidence of gestational diabetes mellitus: Northern California, 1991–2000. Obstet Gynecol 2004; 103: 526-33.
61. Ferraiolo A, Bordone C, Ramone A, Sala P, Gorlero F, Gustavino C, et al. Universal versus risk factor screening for gestational diabetes mellitus. Clinical and Experimental Obstetrics & Gynecology 2018; 45: 53-7.
62. Sufrin CB, Ross JS. Pharmaceutical industry marketing: Understanding its impact on women’s health. Obstet Gynecol Surv 2008; 63: 585-96.
63. Badell ML, Ramin SM, Smith JA. Treatment options for nausea and vomiting during pregnancy. Pharmacotherapy 2006; 26: 1273-87.
64. Cooper WO, Willy ME, Pont SJ, Ray WA. Increasing use of antidepressants in pregnancy. Am J Obstet Gynecol 2007; 196: 544.e1-5.
65. Korenstein D, Keyhani S, Mendelson A, Ross JS. Adherence of pharmaceutical advertisements in medical journals to FDA guidelines and content for safe prescribing. PLoS One 2011; 6: e23336.
66. Taheri C, Kirubarajan A, Li X, Lam ACL, Taheri S, Olivieri NF. Discrepancies in self-reported financial conflicts of interest disclosures by physicians: a systematic review. BMJ Open 2021; 11: e045306.
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| Files | ||
| Issue | Vol 15, No 3 (September 2021) | |
| Section | Review Articles | |
| DOI | https://doi.org/10.18502/jfrh.v15i3.7133 | |
| Keywords | ||
| Health Literacy Pregnancy Drug Safety | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Kirubarajan A, Lam A, Yu A, Taheri C, Khan S, Sethuram C, Mehta V, Olivieri N. Knowledge, Information Sources, and Institutional Trust of Patients Regarding Medication Use in Pregnancy: A Systematic Review. J Family Reprod Health. 2021;15(3):160-171.
