Yıl: 2021 Cilt: 25 Sayı: 2 Sayfa Aralığı: 218 - 229 Metin Dili: İngilizce DOI: 10.29228/jrp.12 İndeks Tarihi: 31-05-2021

Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy

Öz:
Pregnancy is a critical aspect of rational use of medicine (RUM) and imposes important responsibilities on the parties. This study aimed to analyze the knowledge, attitudes, and behaviors of the physicians and pharmacists regarding pharmacotherapy in pregnancy.The data were collected between April 2016-July 2017 by questionnaires and analyses of the prescriptions in Northern Cyprus. Simulated prescriptions (n=50) for pregnant women (PW) were applied at pharmacies, and pharmacists’ (n=95) and obstetricians’ (n=30) attitudes were evaluated through surveys. In addition, PW prescriptions (n=122) were collected from pharmacies and evaluated. All data were re-obtained after one year.The mean number of drugs per PW prescription was 1.48±0.73. In teratogenicity risk evaluation, 6.6% of medicines were in “D/X” and 16.7% were in “C” categories. The ratio of these three categories medicines in scripts was about eight times higher than which was considered as teratogenic based on physicians’ opinions. Serious shortcomings were found in writing the format information in prescriptions. In simulated prescription analysis, mean dispensing time was 3.3±2.3 min. Almost half of the pharmacists wereobserved to give the drug requested by simulated PW without any confirmation of the prescription. The dispensing performances of the pharmacists were mainly different than their related statements on the survey.Our study highlighted the deficiencies in physicians’ and pharmacists’ RUM knowledge, attitudes, and behaviors in pregnancy, where the gaps seem unchanged after one year. These findings underline necessity of education and counselling service interventions for healthcare providers to disseminate RUM in pregnancy.
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Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • [1] Olesen C, Thrane N, Henriksen TB, Ehrenstein V, Olsen J. Associations between socio-economic factors and the use of prescription medication during pregnancy: a population-based study among 19,874 Danish women. Eur J Clin Pharmacol. 2006; 62(7): 547-553. [CrossRef]
  • [2] Başgül A, Akici A, Uzuner A, Kalaça S, Kavak ZN, Tural A, Oktay S. Drug utilization and teratogenicity risk categories during pregnancy. Adv Ther. 2007; 24(1): 68-80. [CrossRef]
  • [3] Lupattelli A, Spigset O, Twigg MJ, Zagorodnikova K, Mardby AC, Moretti ME, Drozd M, Panchaud A, Hameen- Anttila K, Rieutord A, Juraski RG, Odalovic M, Kennedy D, Rudolf G, Juch H, Passier A, Björnsdottir I, Nordeng H. Medication use in pregnancy: across-sectional, multinational web-based study. BMJ Open. 2014; 4(2): e004365. [CrossRef]
  • [4] Pisa FE, Casetta A, Clagnan E, Michelesio E, Brumatti LV and Barbone F. Medication use during pregnancy, gestational age and date of delivery: agreement between maternal self-reports and health database information in a cohort. BMC Pregnancy and Childbirth. 2015; 15: 310. [CrossRef]
  • [5] WHO. The rational use of drugs: report of the conference of experts. World Health Organization; Nairobi, 25-29 November 1985. ISBN 92 4 156105 X
  • [6] State Planning Organization. Population and indicators. http://www.devplan.org/Frame-tr.html (accessed on 09 June 2020)
  • [7] Rohra DK, Das N, Azam SI, Solangi NA, Memon Z, Shaikh AM and Khan MH. Drug prescribing patterns during pregnancy in tertiary care hospitals of Pakistan: a cross sectional study. BMC Pregnancy and Childbirth. 2008; 8: 1- 5. [CrossRef]
  • [8] Al-Hamimi and Al Balushi KA. Patterns of prescription drugs use among pregnant women at Sultan Qaboos University Hospital and Sultan Qaboos University Hospital Family and Community Medicine Clinic, Oman. J Pharm Bioallied Sci. 2006; 8(4): 309-313. [CrossRef]
  • [9] De Vries TP, Henning RH, Hogerzeil HV, Fresle DA. Guide to good prescribing. A practical manual. Geneva: WHO/DAP/94.11. World Health Organization. Action Programme on Essential Drugs. 1994; 6-75.
  • [10] Akici A, Kalaça S, Uğurlu MU, Karaalp A, Çali Ş ve Oktay Ş. Impact of a short postgraduate course in rational pharmacotherapy for general practitioners. Br J Clin Pharmaocol. 2004; 57(3): 310-321. [CrossRef]
  • [11] Bloor M, Paech M. Nonsteroidal anti-inflammatory drugs during pregnancy and the initiation of lactation. Anesth Analg. 2013; 116(5): 1063-1075. [CrossRef]
  • [12] Lee E, Maneno MK, Smith L, Weiss SR, Zuckerman IH, Wutoh AK and Xue Z. National patterns of medication use during pregnancy. Pharmacoepidemiol Drug Saf. 2006; 15(8): 537-545. [CrossRef]
  • [13] Andrade SE, Gurwitz JH, Davis RL, Chan KA, Finkelstein JA, Fortman K, McPhillips H, Raebel MA, Roblin D, Smith DH, Yood MU, Morse AN, Platt R. Prescription drug use in pregnancy. Am J Obstet Gynecol. 2004; 191(2): 398-407. [CrossRef]
  • [14] Andrade SE, Raebel MA, Morse AN, Davis RL, Chan KA, Finkelstein JA, Smith DH, Yood MU, Platt R and Gurwitz JH. Use of prescription medications with a potential for fetal harm among pregnant women. Pharmaco-epidemiol. Drug Saf. 2006; 15(8): 546-554. [CrossRef]
  • [15] Zomerdijk IM, Ruiter R, Houweling LMA, Herings RMC, Straus SMJM, Stricker BH. Dispensing of potentially teratogenic drugs before conception and during pregnancy: a population-based study. BJOG. 2015; 122(8): 1119-1129. [CrossRef]
  • [16] Gagne JJ, Maio V, Barghella V, Louis DZ, Gonnella JS. Prescription drug use during pregnancy: a population-based study in regione Emilia-Romagna, Italy. Eur J Clin Pharmacol. 2008; 64(11): 1125-1132. [CrossRef]
  • [17] Meridian Medical Technologies. Product Information: Cyanokit(R) IV injection, hydroxocobalamin IV injection. Meridian. Medical. Technologies, Inc, Columbia, MD, 2011.
  • [18] Picciano MF. Pregnancy and lactation: Physiological adjustments, nutritional requirements and the role of dietary supplements. J Nutr. 2003; 133(6): 1997S-2002S. [CrossRef]
  • [19] Egen-Lappe V, Hasford J. Drug prescription in pregnancy: analysis of a large statutory sickness fund population. Eur J Clin Pharmacol. 2004; 60(9): 659-666. [CrossRef]
  • [20] Zaki NM, Albarraq AA. Use, attitudes and knowledge of medications among pregnant women: A Saudi Study. Saudi. Pharm. J. 2014; 22(5): 419-428. [CrossRef]
  • [21] Rohra DK, Das N, Azam SI, Solangi NA, Memon Z, Shaikh AM and Khan MH. Drug prescribing patterns during pregnancy in tertiary care hospitals of Pakistan: a cross sectional study. BMC Pregnancy and Childbirth. 2008; 8: 24. [CrossRef]
  • [22] Holst L, Wright D, Haavik S, Nordeng H. The use and the user of herbal remedies during pregnancy. J Altern Complement Med. 2009; 15(7): 787-792. [CrossRef]
  • [23] Lapi F, Vannacci A, Moschini M, Cipollini F, Morsuillo M, Gallo E, Banchelli G, Cecchi E, Di Pirro M, Giovannini MG, Cariglia MT, Gori L, Firenzuoli F, Mugelli A. Use, attitudes and knowledge of complementary and alternative drugs (CADs) among pregnant women: a preliminary survey in Tuscany. Evid Based Complement Alternat Med. 2008; 7(4): 477-486. [CrossRef]
  • [24] Nordeng H, Havnen GC. Use of herbal drugs in pregnancy: a survey among 400 Norwegian women. Pharmacoepidemiol Drug Saf. 2004; 13(6): 371-380. [CrossRef]
  • [25] Schaefer C, Amoura-Elefant E, Vial T, Ornoy A, Gabris H, Robert E, Rodriquez-Pinilla E, Pexieder T, Prapas N and Merlob P. Pregnancy outcome after prenatal quinolone exposure: evaluation of a case registry of the European network of teratology information services (ENTIS). Eur J Obstet Gynecol Reprod Biol. 1996; 69(2): 83-89. [CrossRef]
  • [26] Koren G. Special Aspects of Perinatal & Pediatric Pharmacology. Katzung BG. (Eds). Basic and Clinical Pharmacology. McGraw Hill, 2012, pp:1041.
  • [27] Toklu HZ, Akici A, Oktay S, Cali S, Sezen SF, Keyer-Uysal M. The pharmacy practice community pharmacists in Turkey. Marmara Pharm J. 2010; 14(1): 53–60. [CrossRef]
  • [28] Gokcekus L, Toklu HZ, Demirdamar R, Gumusel B. Dispensing practice in the community pharmacies in the Turkish Republic of Northern Cyprus. Int J Clin Pharm. 2012; 34(2): 312–324. [CrossRef]
  • [29] Santos VD, Nitrini O. Prescription and patient-care indicators in healthcare services Rev. Saude Publica. 2004; 38(6): 819-826. [CrossRef]
  • [30] Erol AYG, Gokcimen A, Ozdemir O. Growth failure, tardive dyskinesia, megacolon development, and hepatic damage in neonatal rats following exposure to trimethobenzamide in utero. J Matern Fetal Neonatal Med. 2011; 24(9): 1176-1180. [CrossRef]
  • [31] Grinceviciene S, Kubiliene L, Ivanauskas K, Drasutiene GS, Ramasauskaite D, Grincevicius J, Bernatoniene J, Savickas A. Experiences of community pharmacists advising pregnant women. Int J Clin Pharm. 2015; 37(4): 636-644. [CrossRef]
  • [32] Carstairs SD. Ondansetron use in pregnancy and birth defects: A systemic review. Obstet. Gynecol. 2016; 127(5): 878- 83. [CrossRef]
  • [33] Zambelli-Weiner A, Via C, Yuen M, Weiner DJ, Kirby RS. First trimester ondansetron exposure and risk of structural birth defects. Reprod Toxicol. 2019; 83: 14-20. [CrossRef]
  • [34] Akici A, Kalaça S, Gören MZ, Akkan AG, Karaalp A, Demir D. Comparison of rational pharmacotherpy decisionmaking competence of general practitioners with intern doctors. Eur J Clin Pharmacol. 2004; 60(2): 75-82. [CrossRef]
  • [35] Toklu HZ and Demirdamar R. The evaluation of prescription dispensing scores of the pharmacy students before and after the problem-based “rational drug use” course: Results of the two years’ experience. Marmara Pharm J. 2013; 17: 175-180. [CrossRef]
  • [36] Briggs GG., Freeman RK., Yaffe SJ, Drugs in pregnancy and lactation, fourth ed., Baltimore, Williams & Wilkins. 1994.
APA Tamirci M, Akici A, Aydin V, Sakarya S, Gören M (2021). Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy. , 218 - 229. 10.29228/jrp.12
Chicago Tamirci Mevhibe,Akici Ahmet,Aydin Volkan,Sakarya Sibel,Gören M. Zafer Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy. (2021): 218 - 229. 10.29228/jrp.12
MLA Tamirci Mevhibe,Akici Ahmet,Aydin Volkan,Sakarya Sibel,Gören M. Zafer Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy. , 2021, ss.218 - 229. 10.29228/jrp.12
AMA Tamirci M,Akici A,Aydin V,Sakarya S,Gören M Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy. . 2021; 218 - 229. 10.29228/jrp.12
Vancouver Tamirci M,Akici A,Aydin V,Sakarya S,Gören M Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy. . 2021; 218 - 229. 10.29228/jrp.12
IEEE Tamirci M,Akici A,Aydin V,Sakarya S,Gören M "Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy." , ss.218 - 229, 2021. 10.29228/jrp.12
ISNAD Tamirci, Mevhibe vd. "Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy". (2021), 218-229. https://doi.org/10.29228/jrp.12
APA Tamirci M, Akici A, Aydin V, Sakarya S, Gören M (2021). Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy. Journal of research in pharmacy (online), 25(2), 218 - 229. 10.29228/jrp.12
Chicago Tamirci Mevhibe,Akici Ahmet,Aydin Volkan,Sakarya Sibel,Gören M. Zafer Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy. Journal of research in pharmacy (online) 25, no.2 (2021): 218 - 229. 10.29228/jrp.12
MLA Tamirci Mevhibe,Akici Ahmet,Aydin Volkan,Sakarya Sibel,Gören M. Zafer Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy. Journal of research in pharmacy (online), vol.25, no.2, 2021, ss.218 - 229. 10.29228/jrp.12
AMA Tamirci M,Akici A,Aydin V,Sakarya S,Gören M Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy. Journal of research in pharmacy (online). 2021; 25(2): 218 - 229. 10.29228/jrp.12
Vancouver Tamirci M,Akici A,Aydin V,Sakarya S,Gören M Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy. Journal of research in pharmacy (online). 2021; 25(2): 218 - 229. 10.29228/jrp.12
IEEE Tamirci M,Akici A,Aydin V,Sakarya S,Gören M "Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy." Journal of research in pharmacy (online), 25, ss.218 - 229, 2021. 10.29228/jrp.12
ISNAD Tamirci, Mevhibe vd. "Evaluation of the knowledge, attitude, and behaviors of physicians and pharmacists regarding the use of medicines in pregnancy". Journal of research in pharmacy (online) 25/2 (2021), 218-229. https://doi.org/10.29228/jrp.12