Accuracy of information on medication use and adverse drug reactions recorded in pregnancy hand-held records

Survey on medication information literacy and influencing factors among pregnant Chinese women

BACKGROUND

The use of medication during pregnancy is very common. Medication safety has been a great concern among pregnant women and is highly influenced by women's medication information literacy (MIL). There have been few studies focusing on MIL of pregnant women in China. The misuse of medication during pregnancy may impose on risks on pregnancy.

OBJECTIVES

The focus of this study was to investigate the MIL of pregnant Chinese women and to identify influencing factors.

METHODS

Convenience sampling was used following the distribution of a researcher-designed questionnaire to pregnant women at obstetric clinics. A scale was developed to evaluate participants' MIL which included medication information needs, medication information sources, medication information quality discrimination, medication information source awareness, and medication-taking behavior. Demographic characteristics of participants, health status and medication use during pregnancy were also collected.

RESULTS

Questionnaires were completed by 570 participants, yielding a 99% response rate. The total score on the Pregnant Women's Medication Information Literacy Scale ranged from 47 to 96 with a mean score of 74.25 ± 8.22. A total score of 80% or higher indicated the participants' have sufficient medication information literacy which was achieved by 28.2% of the sample. Rate of participants who have sufficient MIL on subscale domains were: medication information needs (76.6%), medication-taking behavior (49.9%), medication information source awareness (26.8%), medication information quality discrimination (17.3%) and medication information sources (15.3%). Significant differences were found in the MIL of participants related to education level, location of residence, occupation, household income, age, weeks of gestation and medication history (p < .05). Binary logistic regression analysis indicated that education, income level, location of residence, occupation, and weeks of gestation affected participants' MIL.

CONCLUSIONS

The overall MIL is low among pregnant Chinese women, which suggests a need for healthcare professionals focusing on medication safety teaching to pregnant women. Interventions by health care professionals in obstetric clinics that promote MIL and prevent adverse events related to medications should be individualized based upon pregnant woman's education level, financial resources, community of residence, occupation and week of gestation.

Adverse drug reactions in high-risk pregnant women: A prospective study

Background

Because pregnant women are often excluded from clinical trials, there is still very limited information about the risk and safety of prescription drugs during pregnancy.

Objective

We aimed to determine the prevalence of Adverse Drug Reactions (ADRs) in high-risk pregnant women after hospital admission. A prospective study was carried out in a teaching maternity hospital in Brazil during six months. Causality of ADRs was assessed through the Naranjo Algorithm and Korean Algorithm for ADR Causality Assessment. Severity of ADRs was assessed using Hartwig’s Severity Assessment Scale.

Results

The prevalence of ADRs among the 294 inpatients studied was 8.8%. The mean age was 27.14 (±7.5) y.o. Patient's age was related to the presence of ADRs, while the manifestation of these events was not associated with any adverse pregnancy outcome. 75.9% of the ADRs reported in the study were of mild severity and 24.1% were of moderate severity. No ADR was caused by drug-drug interaction; however, a significant increase in blood pressure was observed in all patients using concurrent methyldopa and ferrous sulfate.

Conclusion

Overall, ADRs were not common events among high-risk pregnant women and no adverse pregnancy outcomes following these events were observed.

The medication reconciliation process and classification of discrepancies: a systematic review

AIMS

Medication reconciliation is a part of the medication management process and facilitates improved patient safety during care transitions. The aims of the study were to evaluate how medication reconciliation has been conducted and how medication discrepancies have been classified.

METHODS

We searched MEDLINE, EMBASE, CINAHL, PubMed, International Pharmaceutical Abstracts (IPA), and Web of Science (WOS), in accordance with the PRISMA statement up to April 2016. Studies were eligible for inclusion if they evaluated the types of medication discrepancy found through the medication reconciliation process and contained a classification system for discrepancies. Data were extracted by one author based on a predefined table, and 10% of included studies were verified by two authors.

RESULTS

Ninety-five studies met the inclusion criteria. Approximately one-third of included studies (n = 35, 36.8%) utilized a 'gold' standard medication list. The majority of studies (n = 57, 60%) used an empirical classification system and the number of classification terms ranged from 2 to 50 terms. Whilst we identified three taxonomies, only eight studies utilized these tools to categorize discrepancies, and 11.6% of included studies used different patient safety related terms rather than discrepancy to describe the disagreement between the medication lists.

CONCLUSIONS

We suggest that clear and consistent information on prevalence, types, causes and contributory factors of medication discrepancy are required to develop suitable strategies to reduce the risk of adverse consequences on patient safety. Therefore, to obtain that information, we need a well-designed taxonomy to be able to accurately measure, report and classify medication discrepancies in clinical practice.