Angela Lupattelli1, Olav Spigset2,3, Ingunn Björnsdóttir1, Katri Hämeen-Anttila4, Ann-Charlotte Mårdby5, Alice Panchaud6, Romana Gjergja Juraski7, Gorazd Rudolf8, Marina Odalovic9, Mariola Drozd10, Michael J Twigg11, Herbert Juch12, Myla E Moretti13, Debra Kennedy14, Andre Rieutord15, Ksenia Zagorodnikova16, Anneke Passier17, Hedvig Nordeng1,18. 1. School of Pharmacy, University of Oslo, Oslo, Norway. 2. Department of Clinical Pharmacology, St. Olav's University Hospital, Trondheim, Norway. 3. Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway. 4. Finnish Medicines Agency, Kuopio, Finland. 5. Research and Development, Sahlgrenska University Hospital, Gothenburg, Sweden. 6. School of Pharmaceutical Sciences, University of Geneva and Lausanne, Geneva, Switzerland. 7. Children's Hospital Srebrnjak, Neuropediatric Unit, Zagreb, Croatia. 8. Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia. 9. Department of Social Pharmacy and Pharmaceutical Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia. 10. Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland. 11. School of Pharmacy, University of East Anglia, Norwich Research Park, UK. 12. Research Unit Human Teratogens, Institute for Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria. 13. The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, University of Toronto, Ontario, Canada. 14. MotherSafe, Royal Hospital for Women and University of NSW, Randwick, Australia. 15. APHP, GH HUPS, Hop Antoine Béclère, Service Pharmacie, Clamart France and Européenne de Formation pour les Pharmaciens, France. 16. Northwest Medical Center for Drug Safety in Pregnancy & Lactation, Northwest State Medical University n.a.I.I.Mechnikov, St. Petersburg, Russia. 17. Teratology Information Service (TIS), Netherlands Pharmacovigilance Centre Lareb, The Netherlands. 18. Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
Abstract
BACKGROUND: No previous studies have explored how closely women follow their psychotropic drug regimens during pregnancy. This study aimed to explore patterns of and factors associated with low adherence to psychotropic medication during pregnancy. METHODS: Multinational web-based study was performed in 18 countries in Europe, North America, and Australia. Uniform data collection was ensured via an electronic questionnaire. Pregnant women were eligible to participate. Adherence was measured via the 8-item Morisky Medication Adherence Scale (MMAS-8). The Beliefs about Prescribed Medicines Questionnaire (BMQ-specific), the Edinburgh Postnatal Depression Scale (EPDS), and a numeric rating scale were utilized to measure women's beliefs, depressive symptoms, and antidepressant risk perception, respectively. Participants reporting use of psychotropic medication during pregnancy (n = 160) were included in the analysis. RESULTS: On the basis of the MMAS-8, 78 of 160 women (48.8%, 95% CI: 41.1-56.4%) demonstrated low adherence during pregnancy. The rates of low adherence were 51.3% for medication for anxiety, 47.2% for depression, and 42.9% for other psychiatric disorders. Smoking during pregnancy, elevated antidepressant risk perception (risk≥6), and depressive symptoms were associated with a significant 3.9-, 2.3-, and 2.5-fold increased likelihood of low medication adherence, respectively. Women on psychotropic polytherapy were less likely to demonstrate low adherence. The belief that the benefit of pharmacotherapy outweighed the risks positively correlated (r = .282) with higher medication adherence. CONCLUSIONS: Approximately one of two pregnant women using psychotropic medication demonstrated low adherence in pregnancy. Life-style factors, risk perception, depressive symptoms, and individual beliefs are important factors related to adherence to psychotropic medication in pregnancy.
BACKGROUND: No previous studies have explored how closely women follow their psychotropic drug regimens during pregnancy. This study aimed to explore patterns of and factors associated with low adherence to psychotropic medication during pregnancy. METHODS: Multinational web-based study was performed in 18 countries in Europe, North America, and Australia. Uniform data collection was ensured via an electronic questionnaire. Pregnant women were eligible to participate. Adherence was measured via the 8-item Morisky Medication Adherence Scale (MMAS-8). The Beliefs about Prescribed Medicines Questionnaire (BMQ-specific), the Edinburgh Postnatal Depression Scale (EPDS), and a numeric rating scale were utilized to measure women's beliefs, depressive symptoms, and antidepressant risk perception, respectively. Participants reporting use of psychotropic medication during pregnancy (n = 160) were included in the analysis. RESULTS: On the basis of the MMAS-8, 78 of 160 women (48.8%, 95% CI: 41.1-56.4%) demonstrated low adherence during pregnancy. The rates of low adherence were 51.3% for medication for anxiety, 47.2% for depression, and 42.9% for other psychiatric disorders. Smoking during pregnancy, elevated antidepressant risk perception (risk≥6), and depressive symptoms were associated with a significant 3.9-, 2.3-, and 2.5-fold increased likelihood of low medication adherence, respectively. Women on psychotropic polytherapy were less likely to demonstrate low adherence. The belief that the benefit of pharmacotherapy outweighed the risks positively correlated (r = .282) with higher medication adherence. CONCLUSIONS: Approximately one of two pregnant women using psychotropic medication demonstrated low adherence in pregnancy. Life-style factors, risk perception, depressive symptoms, and individual beliefs are important factors related to adherence to psychotropic medication in pregnancy.
Authors: Elizabeth C Ailes; Regina M Simeone; April L Dawson; Emily E Petersen; Suzanne M Gilboa Journal: Birth Defects Res A Clin Mol Teratol Date: 2016-11
Authors: Susan E Andrade; Anick Bérard; Hedvig M E Nordeng; Mollie E Wood; Marleen M H J van Gelder; Sengwee Toh Journal: Curr Epidemiol Rep Date: 2017-04-18