Zane R Gallinger1, Amir Rumman2, Geoffrey C Nguyen3. 1. Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, ON, Canada. 2. Department of Medicine, University of Toronto, Toronto, ON, Canada. 3. Mount Sinai Hospital Centre for Inflammatory Bowel Disease, University of Toronto, Toronto, ON, Canada geoff.nguyen@utoronto.ca.
Abstract
BACKGROUND AND AIMS: Women with inflammatory bowel disease [IBD] report concerns about medication safety during pregnancy. Adherence to IBD medications may be lower in pregnant patients as a result. The aim of this study was to assess medication adherence during pregnancy in women with inflammatory bowel disease. METHODS: Female patients of childbearing age completed a self-administered, structured survey. We collected demographic data, medication history, and self-reported adherence to IBD medications during pregnancy. We also assessed knowledge and perceptions of IBD medication safety in pregnancy. A time trade-off [TTO] analysis was done to assess health utilities for continuing or discontinuing IBD medications during pregnancy. RESULTS: A total of 204 women completed the survey [mean age was 32.8 years]. Current or previous pregnancy was reported by 101 patients [median parity 2, median gravity 1]. While pregnant or attempting to conceive, 47 [46.5%] participants reported stopping a prescribed IBD medication. Of those, 20 participants reported stopping medications without the advice of a physician. TTO analysis was completed by 31 patients. When presented with the option of continuing a potentially teratogenic medication, switching to less effective medication that is non-teratogenic, or stopping medication all together, participants consistently preferred to not remain on the most effective IBD therapy. CONCLUSIONS: Women with IBD report preference to not remain on IBD medications during pregnancy. This is driven by concerns about safety and uncertainty about teratogenic effects. Women with IBD may benefit from increased education about medication safety in pregnancy.
BACKGROUND AND AIMS: Women with inflammatory bowel disease [IBD] report concerns about medication safety during pregnancy. Adherence to IBD medications may be lower in pregnant patients as a result. The aim of this study was to assess medication adherence during pregnancy in women with inflammatory bowel disease. METHODS: Female patients of childbearing age completed a self-administered, structured survey. We collected demographic data, medication history, and self-reported adherence to IBD medications during pregnancy. We also assessed knowledge and perceptions of IBD medication safety in pregnancy. A time trade-off [TTO] analysis was done to assess health utilities for continuing or discontinuing IBD medications during pregnancy. RESULTS: A total of 204 women completed the survey [mean age was 32.8 years]. Current or previous pregnancy was reported by 101 patients [median parity 2, median gravity 1]. While pregnant or attempting to conceive, 47 [46.5%] participants reported stopping a prescribed IBD medication. Of those, 20 participants reported stopping medications without the advice of a physician. TTO analysis was completed by 31 patients. When presented with the option of continuing a potentially teratogenic medication, switching to less effective medication that is non-teratogenic, or stopping medication all together, participants consistently preferred to not remain on the most effective IBD therapy. CONCLUSIONS:Women with IBD report preference to not remain on IBD medications during pregnancy. This is driven by concerns about safety and uncertainty about teratogenic effects. Women with IBD may benefit from increased education about medication safety in pregnancy.
Authors: Sonia Roldan Munoz; Angela Lupattelli; Sieta T de Vries; Peter G M Mol; Hedvig Nordeng Journal: BMJ Open Date: 2020-02-05 Impact factor: 2.692
Authors: Reed T Sutton; Kelsey Wierstra; Jasmin Bal; Kathleen P Ismond; Levinus A Dieleman; Brendan P Halloran; Karen I Kroeker; Richard N Fedorak; Keri-Ann Berga; Vivian W Huang Journal: J Can Assoc Gastroenterol Date: 2019-12-19
Authors: Freddy J K Toloza; Sarah E Theriot; Naykky M Singh Ospina; Sameen Nooruddin; Brooke Keathley; Stacey M Johnson; Nalin Payakachat; Elena Ambrogini; Rene Rodriguez-Gutierrez; Derek T O'Keeffe; Juan P Brito; Victor M Montori; Nafisa K Dajani; Spyridoula Maraka Journal: Thyroid Date: 2021-01-19 Impact factor: 6.568