Nina M Molenaar1, Marlies E Brouwer2, Johannes J Duvekot3, Huibert Burger4, Esther M Knijff5, Witte J Hoogendijk6, Claudi L H Bockting7, G S de Wolf8, Mijke P Lambregtse-van den Berg9. 1. Department of Psychiatry, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: n.m.molenaar@erasmusmc.nl. 2. Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands. Electronic address: m.e.brouwer@uu.nl. 3. Department of Obstetrics and Gynaecology, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: j.j.duvekot@erasmusmc.nl. 4. Department of General Practice, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. Electronic address: h.burger@umcg.nl. 5. Department of Psychiatry, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: e.knijff@erasmusmc.nl. 6. Department of Psychiatry, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: w.hoogendijk@erasmusmc.nl. 7. Department of Psychiatry, Academic Medical Center Amsterdam, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands. Electronic address: c.l.h.bockting@uu.nl. 8. Department of Clinical Methods and Public Health, Amsterdam Medical Center, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands. Electronic address: g.s.dewolf@amc.uva.nl. 9. Department of Psychiatry, Erasmus Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Electronic address: mijke.vandenberg@erasmusmc.nl.
Abstract
BACKGROUND AND OBJECTIVES: prescription rates of antidepressants during pregnancy range from 2-3% in The Netherlands to 6.2% in the USA. Inconclusive evidence about harms and benefits of antidepressants during pregnancy leads to variation in advice given by gynaecologists and midwives. The objective was to investigate familiarity with, and adherence to the Dutch multidisciplinary guideline on Selective Serotonin Reuptake Inhibitor (SSRI) use during pregnancy by gynaecologists and midwives in the Netherlands. METHODS: an online survey was developed and send to Dutch gynaecologists and midwives. The survey consisted mainly of multiple-choice questions addressing guideline familiarity and current practice of the respondent. Also, caregiver characteristics associated with guideline adherence were investigated. FINDINGS: a total of 178 gynaecologists and 139 midwives responded. Overall familiarity with the Dutch guideline was 92.7%. However, current practice and advice given to patients by caregivers differed substantially, both between gynaecologists and midwives as well as within both professions. Overall guideline adherence was 13.9%. Multivariable logistic regression showed that solely caregiver profession was associated with guideline adherence, with gynaecologists having a higher adherence rate (OR 2.10, 95%CI 1.02-4.33) than midwives. KEY CONCLUSION: although reported familiarity with the guideline is high, adherence to the guideline is low, possibly resulting in advice to patients that is inconsistent with guidelines and unwanted variation in current practice. IMPLICATIONS FOR PRACTICE: further implementation of the recommendations as given in the guideline should be stimulated. Additional research is needed to examine how gynaecologists and midwives can be facilitated to follow the recommendations of the clinical guideline on SSRI use during pregnancy.
BACKGROUND AND OBJECTIVES: prescription rates of antidepressants during pregnancy range from 2-3% in The Netherlands to 6.2% in the USA. Inconclusive evidence about harms and benefits of antidepressants during pregnancy leads to variation in advice given by gynaecologists and midwives. The objective was to investigate familiarity with, and adherence to the Dutch multidisciplinary guideline on Selective Serotonin Reuptake Inhibitor (SSRI) use during pregnancy by gynaecologists and midwives in the Netherlands. METHODS: an online survey was developed and send to Dutch gynaecologists and midwives. The survey consisted mainly of multiple-choice questions addressing guideline familiarity and current practice of the respondent. Also, caregiver characteristics associated with guideline adherence were investigated. FINDINGS: a total of 178 gynaecologists and 139 midwives responded. Overall familiarity with the Dutch guideline was 92.7%. However, current practice and advice given to patients by caregivers differed substantially, both between gynaecologists and midwives as well as within both professions. Overall guideline adherence was 13.9%. Multivariable logistic regression showed that solely caregiver profession was associated with guideline adherence, with gynaecologists having a higher adherence rate (OR 2.10, 95%CI 1.02-4.33) than midwives. KEY CONCLUSION: although reported familiarity with the guideline is high, adherence to the guideline is low, possibly resulting in advice to patients that is inconsistent with guidelines and unwanted variation in current practice. IMPLICATIONS FOR PRACTICE: further implementation of the recommendations as given in the guideline should be stimulated. Additional research is needed to examine how gynaecologists and midwives can be facilitated to follow the recommendations of the clinical guideline on SSRI use during pregnancy.
Authors: Nina M Molenaar; Marlies E Brouwer; Astrid M Kamperman; Huibert Burger; Alishia D Williams; Witte J G Hoogendijk; Claudi L H Bockting; Mijke P Lambregtse-van den Berg Journal: PLoS One Date: 2019-02-22 Impact factor: 3.240
Authors: Sarah Kittel-Schneider; Ethel Felice; Rachel Buhagiar; Mijke Lambregtse-van den Berg; Claire A Wilson; Visnja Banjac Baljak; Katarina Savic Vujovic; Branislava Medic; Ana Opankovic; Ana Fonseca; Angela Lupattelli Journal: Int J Environ Res Public Health Date: 2022-02-10 Impact factor: 3.390
Authors: Babette Bais; Astrid M Kamperman; Hilmar H Bijma; Witte Jg Hoogendijk; Jan L Souman; Esther Knijff; Mijke P Lambregtse-van den Berg Journal: BMJ Open Date: 2020-10-28 Impact factor: 2.692