Prevalence of prescribing in pregnancy using the Irish primary care research network: a pilot study
| Autor: | Rowan Schelten, Kirsty K O'Brien, David R Walsh, Adam Roche, Rose Galvin, Erica Donnelly-Swift, Kate Cronin, Paul Dillon, Ronan McDonnell, Susan M Smith, Tom Fahey |
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| Přispěvatelé: | HRB |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty Prescription Drugs Pregnancy High-Risk medication use Reproductive medicine Pilot Projects Prenatal care General medical services Cohort Studies FDA pregnancy-risk categories Pregnancy Obstetrics and Gynaecology Medicine Electronic Health Records Humans Medical prescription Practice Patterns Physicians' Retrospective Studies Medication use Primary Health Care business.industry prescribing Pregnancy Outcome Obstetrics and Gynecology Retrospective cohort study Prenatal Care medicine.disease Prescribing Cohort Female pregnancy Pregnant Women business Ireland Cohort study Research Article |
| Zdroj: | BMC Pregnancy and Childbirth |
| ISSN: | 1471-2393 |
| Popis: | peer-reviewed Background: To establish the prevalence and patterns of prescribing to pregnant women in an Irish primary care setting. Methods: We reviewed electronic healthcare records routinely collected in primary care, of pregnant women attending nine Dublin-based General Practices affiliated to the Irish Primary Care Research Network (IPCRN) for antenatal care between January 2007 and October 2013 (n = 2,361 pregnancies). Results: Excluding folic acid, 46.8% (n = 1,104) of pregnant women were prescribed at least one medication. Amoxicillin (11.1%, n = 263) and co-amoxiclav (8.0%, n = 190) were the most commonly prescribed medication followed by topical clotrimazole (4.9%, n = 117), salbutamol inhalers (4.1%, n = 96) and paracetamol (4.0%, n = 95). General Medical Services (GMS) patients were more likely to receive a prescription than private patients (OR 2.81; 95%CI (2.28, 3.47)). We applied the US FDA pregnancy-risk categories as a proxy measure of prescribing appropriateness, with FDA Category D and X medications considered inappropriate. FDA Category D drugs were prescribed in 5.9% (n = 140) of pregnancies. FDA Category X drugs were prescribed in 4.9% (n = 116) of pregnancies but after exclusion of oral contraceptives, progestogens, infertility treatments Category X medications were prescribed in 0.6% (n = 13) of pregnancies. After the initial antenatal consultation the prescribing prevalence of FDA Category D medications reduced to 4.7% (n = 110) and Category X to 3.1% (n = 72). Conclusions: The overall prevalence of prescribing to pregnant women in our cohort is low compared to studies internationally, however similar levels of prescribing for FDA Category D and X were found. Following the initial antenatal consultation levels of prescribing of the FDA Category D and X medications reduced, however there is potential to further reduce their use in early pregnancy. The IPCRN database has provided valuable information on the current practice of antenatal prescribing within this pilot group of practices however it is limited by the absence of morbidity and pregnancy outcome data. |
| Databáze: | OpenAIRE |
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