Yıl: 2021 Cilt: 8 Sayı: 1 Sayfa Aralığı: 49 - 56 Metin Dili: İngilizce DOI: 10.14744/nci.2020.27003 İndeks Tarihi: 19-06-2021

Evaluation of the pregnant women’s approaches regarding drug utilization

Öz:
OBJECTIVE: Drug utilization habits of the pregnant are a critical aspect of rational use of the medicine (RUM). This study aimed to analyze the RUM related attitudes and the behaviors of women during their pregnancies.METHODS: The data were collected between May 2016–October 2016 by conducting surveys to 71 pregnant women admit-ted to the private and governmental hospitals in five districts of Northern Cyprus. The sociodemographic characteristics of the pregnant as well as their attitudes and behaviors concerning drug use were evaluated.RESULTS: The mean age and the gestational week of the patients was 29.7±4.3 years and 25.7±11.2 weeks, respectively. Planned pregnancies constituted 71.8% of all. The percentage of patients with an unplanned pregnancies who were using drugs at the time of the survey (25.0%) was lower than that in those with planned pregnancies (49.0%, p<0.05). Almost two-thirds (66.2%) of the women were exposed to a drug during pregnancy, mostly for “vitamin/mineral prophylaxis” (38.3%) and agents controlling nausea/vomiting (19.1%). Two out of eleven women (18.2%) were using folic acid when they learned about their pregnancy. One of the drugs used for the chronic disorder in the third trimester was acetylsalicylic acid (11.1%), a cate-gory D drug in this setting. Most of the patients stated that they frequently read the instructions (60.9%), “often” paying atten-tion to side effects (56.5%). Considering some of the habits related to drug use, 8.7% and 10.9% of pregnant women declared that they sometimes “did not follow the instructions” and “dosage/duration of the drug usage”, respectively. Seven patients (15.2%) declared that they did not consider side effects on the medication guide while more than half (56.5%) did it “often“. Near one in five (19.6%) of the pregnant women stated that they hesitated about the drug usage due to teratogenicity risks.CONCLUSION: Our study highlights the drug utilization attitudes and behaviors of pregnant women during pregnancy in Northern Cyprus, indicating several shortcomings, including insufficient prenatal folic acid use, occasional use of risky drugs, and unsatisfactory medication guide handling. Available findings underline the necessity of education not only for patients but also for healthcare providers to disseminate RUM in pregnancy.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Bakker MK, Jentink J, Vroom F, Van Den Berg PB, De Walle HE, De Jong-Van Den Berg LT. Drug prescription patterns before, during and after pregnancy for chronic, occasional and pregnancy-related drugs in the Netherlands. BJOG 2006;113:559–68.
  • 2. Basgül A, Akici A, Uzuner A, Kalaça S, Kavak ZN, Tural A, et al. Drug utilization and teratogenicity risk categories during pregnancy. Adv Ther 2007;24:68–80.
  • 3. Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernández- Díaz S; National Birth Defects Prevention Study. Medication use during pregnancy, with particular focus on prescription drugs: 1976- 2008. Am J Obstet Gynecol 2011;205:51.e1–8.
  • 4. Lupattelli A, Spigset O, Twigg MJ, Zagorodnikova K, Mårdby AC, Moretti ME, et al. Medication use in pregnancy: a cross-sectional, multinational web-based study. BMJ Open 2014;4:e004365.
  • 5. Koren G. Section X. Chapter 59. Special Aspects of Peinatal & Pediatric Pharmacology. In: Katzung BG, editor. Basic and Clinical Pharmacology. Lange; 2012. p. 1041
  • 6. World Health Organization. The Rational use of drugs: report of the conference of experts. World Health Organization; Nairobi, 25-29 November 1985. Availabe at: https://apps.who.int/iris/handle/ 10665/37174. Accessed Dec 02, 2020.
  • 7. Delgado-Rodríguez M, Gómez-Olmedo M, Bueno-Cavanillas A, Gálvez-Vargas R. Unplanned pregnancy as a major determinant in inadequate use of prenatal care. Prev Med 1997;26:834–8.
  • 8. Kuroki LM, Allsworth JE, Redding CA, Blume JD, Peipert JF. Is a previous unplanned pregnancy a risk factor for a subsequent unplanned pregnancy? Am J Obstet Gynecol 2008;199:517.e1–7.
  • 9. Yanikkerem E, Ay S, Piro N. Planned and unplanned pregnancy: effects on health practice and depression during pregnancy. J Obstet Gynaecol Res 2013;39:180–7.
  • 10. Karaçam Z, Onel K, Gerçek E. Effects of unplanned pregnancy on maternal health in Turkey. Midwifery 2011;27:288–93.
  • 11. KKTC Devlet Planlama Örgütü: 2011 Nüfus Sayımı [State Planning Organization of the Northern Cyprus: Population Census of the Year 2011]. Available at: http://www.devplan.org/Nufus-2011/Nufus- 2011.html Accessed Feb 18, 2020.
  • 12. KKTC Turist Sağlık Rehberi [Health Guide for Tourists in the Northern Cyprus]. Available at: http://www.saglikbakanligi.com/ html_files/%20yayinlar/turist_saglik_rehberi/Turistin_kktc_saglik_ rehberi.pdf. Accessed Feb 18, 2020.
  • 13. Akıcı A, Tamirci M, Gören MZ. The Impacts of the Physiological Changes Occurring During Pregnancy on Pharmacokinetic Mechanisms. Clinical and Experimental Health Sciences 2017;7:71–7.
  • 14. Openshaw MR, Bomela HN, Pretlove S. An Evaluation of the Timing and Use of Healthcare during Pregnancy in Birmingham, UK and Pretoria, South Africa. ISRN Obstet Gynecol 2011;2011:364243.
  • 15. Varghese BM, Vanaja K, Banu R. Assessment of drug usage pattern during pregnancy at a tertiary care teaching hospital. Int J Med Public Health 2016;6:130–5.
  • 16. Abrahams N, Jewkes R, Mvo Z. Health care-seeking practices of pregnant women and the role of the midwife in Cape Town, South Africa. J Midwifery Womens Health 2001;46:240–7.
  • 17. Uzuner A, Başgül A, Kalaça S, Kavak ZN, Tural A, Oktay Ş, et al. First Recognition Time Of Pregnancy And Related Factors. Türk Aile Hek Derg 2006;10:156–9.
  • 18. Wellings K, Jones KG, Mercer CH, Tanton C, Clifton S, Datta J, et al. The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet 2013;382:1807–16.
  • 19. Czeizel AE. Prevention of congenital abnormalities by periconceptional multivitamin supplementation. BMJ 1993;306:1645–8.
  • 20. Czeizel AE. Reduction of urinary tract and cardiovascular defects by periconceptional multivitamin supplementation. Am J Med Genet 1996;62:179–83.
  • 21. Hayes C, Werler MM, Willett WC, Mitchell AA. Case-control study of periconceptional folic acid supplementation and oral clefts. Am J Epidemiol 1996;143:1229–34.
  • 22. Wilson RD; Genetics Committee; Motherisk. Pre-conceptional vitamin/ folic acid supplementation 2007: the use of folic acid in combination with a multivitamin supplement for the prevention of neural tube defects and other congenital anomalies. J Obstet Gynaecol Can 2007;29:1003–13.
  • 23. Egen-Lappe V, Hasford J. Drug prescription in pregnancy: analysis of a large statutory sickness fund population. Eur J Clin Pharmacol 2004;60:659–66.
  • 24. Akıcı A, Tamirci M, Gören MZ. Rational use of medicine in pregnancy and the roles of health providers. In: Akıcı A, editor. Lefkoşa; 2017. p. 5–56.
  • 25. Zaki NM, Albarraq AA. Use, attitudes and knowledge of medications among pregnant women: A Saudi study. Saudi Pharm J 2014;22:419– 28.
  • 26. Holst L, Wright D, Haavik S, Nordeng H. The use and the user of herbal remedies during pregnancy. J Altern Complement Med 2009;15:787–92.
  • 27. Lapi F, Vannacci A, Moschini M, Cipollini F, Morsuillo M, Gallo E, et al. Use, Attitudes and Knowledge of Complementary and Alternative Drugs (CADs) Among Pregnant Women: a Preliminary Survey in Tuscany. Evid Based Complement Alternat Med 2010;7:477–86.
  • 28. Nordeng H, Havnen GC. Use of herbal drugs in pregnancy: a survey among 400 Norwegian women. Pharmacoepidemiol Drug Saf 2004;13:371–80.
  • 29. Andrade SE, Gurwitz JH, Davis RL, Chan KA, Finkelstein JA, Fortman K, et al. Prescription drug use in pregnancy. Am J Obstet Gynecol 2004;191:398–407.
  • 30. Abduelkarem AR, Mustafa H. Use of Over-the-Counter Medication among Pregnant Women in Sharjah, United Arab Emirates. J Pregnancy 2017;2017:4503793.
  • 31. Bercaw J, Maheshwari B, Sangi-Haghpeykar H. The use during pregnancy of prescription, over-the-counter, and alternative medications among Hispanic women. Birth 2010;37:211–8.
  • 32. Abasiubong F, Bassey EA, Udobang JA, Akinbami OS, Udoh SB, Idung AU. Self-Medication: potential risks and hazards among pregnant women in Uyo, Nigeria. Pan Afr Med J 2012;13:15.
  • 33. Refuerzo JS, Blackwell SC, Sokol RJ, Lajeunesse L, Firchau K, Kruger M, et al. Use of over-the-counter medications and herbal remedies in pregnancy. Am J Perinatol 2005;22:321–4.
  • 34. 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.
  • 35. De Vigan C, De Walle HE, Cordier S, Goujard J, Knill-Jones R, Aymé S, et al. Therapeutic drug use during pregnancy: a comparison in four European countries. OECM Working Group. Occupational Exposures and Congenital Anomalies. J Clin Epidemiol 1999;52:977–82.
  • 36. Beyens MN, Guy C, Ratrema M, Ollagnier M. Prescription of drugs to pregnant women in France: the HIMAGE study. Therapie 2003;58:505–11.
  • 37. Olesen C, Steffensen FH, Nielsen GL, de Jong-van den Berg L, Olsen J, Sørensen HT. Drug use in first pregnancy and lactation: a population- based survey among Danish women. The EUROMAP group. Eur J Clin Pharmacol 1999;55:139–44.
  • 38. Smedberg J, Bråthen M, Waka MS, Jacobsen AF, Gjerdalen G, Nordeng H. Medication use and drug-related problems among women at maternity wards-a cross-sectional study from two Norwegian hospitals. Eur J Clin Pharmacol 2016;72:849–57.
  • 39. Pisa FE, Casetta A, Clagnan E, Michelesio E, Vecchi Brumatti L, 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 Childbirth 2015;15:310.
  • 40. McDonald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions: scientific review. JAMA 2002;288:2868–79.
APA Tamirci M, Aydin V, Soyalan M, Akıcı N, Gören M, Akici A (2021). Evaluation of the pregnant women’s approaches regarding drug utilization. , 49 - 56. 10.14744/nci.2020.27003
Chicago Tamirci Mevhibe,Aydin Volkan,Soyalan Mertdogan,Akıcı Narin,Gören M. Zafer,Akici Ahmet Evaluation of the pregnant women’s approaches regarding drug utilization. (2021): 49 - 56. 10.14744/nci.2020.27003
MLA Tamirci Mevhibe,Aydin Volkan,Soyalan Mertdogan,Akıcı Narin,Gören M. Zafer,Akici Ahmet Evaluation of the pregnant women’s approaches regarding drug utilization. , 2021, ss.49 - 56. 10.14744/nci.2020.27003
AMA Tamirci M,Aydin V,Soyalan M,Akıcı N,Gören M,Akici A Evaluation of the pregnant women’s approaches regarding drug utilization. . 2021; 49 - 56. 10.14744/nci.2020.27003
Vancouver Tamirci M,Aydin V,Soyalan M,Akıcı N,Gören M,Akici A Evaluation of the pregnant women’s approaches regarding drug utilization. . 2021; 49 - 56. 10.14744/nci.2020.27003
IEEE Tamirci M,Aydin V,Soyalan M,Akıcı N,Gören M,Akici A "Evaluation of the pregnant women’s approaches regarding drug utilization." , ss.49 - 56, 2021. 10.14744/nci.2020.27003
ISNAD Tamirci, Mevhibe vd. "Evaluation of the pregnant women’s approaches regarding drug utilization". (2021), 49-56. https://doi.org/10.14744/nci.2020.27003
APA Tamirci M, Aydin V, Soyalan M, Akıcı N, Gören M, Akici A (2021). Evaluation of the pregnant women’s approaches regarding drug utilization. İstanbul Kuzey Klinikleri, 8(1), 49 - 56. 10.14744/nci.2020.27003
Chicago Tamirci Mevhibe,Aydin Volkan,Soyalan Mertdogan,Akıcı Narin,Gören M. Zafer,Akici Ahmet Evaluation of the pregnant women’s approaches regarding drug utilization. İstanbul Kuzey Klinikleri 8, no.1 (2021): 49 - 56. 10.14744/nci.2020.27003
MLA Tamirci Mevhibe,Aydin Volkan,Soyalan Mertdogan,Akıcı Narin,Gören M. Zafer,Akici Ahmet Evaluation of the pregnant women’s approaches regarding drug utilization. İstanbul Kuzey Klinikleri, vol.8, no.1, 2021, ss.49 - 56. 10.14744/nci.2020.27003
AMA Tamirci M,Aydin V,Soyalan M,Akıcı N,Gören M,Akici A Evaluation of the pregnant women’s approaches regarding drug utilization. İstanbul Kuzey Klinikleri. 2021; 8(1): 49 - 56. 10.14744/nci.2020.27003
Vancouver Tamirci M,Aydin V,Soyalan M,Akıcı N,Gören M,Akici A Evaluation of the pregnant women’s approaches regarding drug utilization. İstanbul Kuzey Klinikleri. 2021; 8(1): 49 - 56. 10.14744/nci.2020.27003
IEEE Tamirci M,Aydin V,Soyalan M,Akıcı N,Gören M,Akici A "Evaluation of the pregnant women’s approaches regarding drug utilization." İstanbul Kuzey Klinikleri, 8, ss.49 - 56, 2021. 10.14744/nci.2020.27003
ISNAD Tamirci, Mevhibe vd. "Evaluation of the pregnant women’s approaches regarding drug utilization". İstanbul Kuzey Klinikleri 8/1 (2021), 49-56. https://doi.org/10.14744/nci.2020.27003