孕期抑郁症：全科医生和药剂师对抗抑郁药使用的看法及信息来源
Depression during pregnancy: views on antidepressant use and information sources of general practitioners and pharmacists.
作者信息
Ververs Tessa, van Dijk Liset, Yousofi Somaye, Schobben Fred, Visser Gerard H A
机构信息
Department of Perinatology and Gynaecology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands.
出版信息
BMC Health Serv Res. 2009 Jul 17;9:119. doi: 10.1186/1472-6963-9-119.
BACKGROUND
The use of antidepressants during pregnancy has increased in recent years. In the Netherlands, almost 2% of all pregnant women are exposed to antidepressants. Although guidelines have been developed on considerations that should be taken into account, prescribing antidepressants during pregnancy is still a subject of debate. Physicians and pharmacists may have opposing views on using medication during pregnancy and may give contradictory advice on whether or not to take medication for depression and anxiety disorders during pregnancy. In this study, we investigated information sources used by general practitioners (GPs) and pharmacists and their common practices.
METHODS
A questionnaire on the use of information sources and the general approach when managing depression during pregnancy was sent out to 1400 health care professionals to assess information sources on drug safety during pregnancy and also the factors that influence decision-making. The questionnaires consisted predominantly of closed multiple-choice questions.
RESULTS
A total of 130 GPs (19%) and 144 pharmacists (21%) responded. The most popular source of information on the safety of drug use during pregnancy is the Dutch National Health Insurance System Formulary, while a minority of respondents contacts the Dutch national Teratology Information Service (TIS). The majority of GPs contact the pharmacy with questions concerning drug use during pregnancy. There is no clear line with regard to treatment or consensus between GPs on the best therapeutic strategy, nor do practitioners agree upon the drug of first choice. GPs have different views on stopping or continuing antidepressants during pregnancy or applying alternative treatment options. The debate appears to be ongoing as to whether or not specialised care for mother and child is indicated in cases of gestational antidepressant use.
CONCLUSION
Primary health care workers are not univocal concerning therapy for pregnant women with depression. Although more research is needed to account for all safety issues, local or national policies are indispensable in order to avoid undesirable practices, such as giving contradictory advice. GPs and pharmacists should address the subject during their regular pharmacotherapeutic consensus meetings, preferably in collaboration with the TIS or other professionals in the field.
背景
近年来，孕期使用抗抑郁药的情况有所增加。在荷兰，几乎2%的孕妇接触过抗抑郁药。尽管已制定了应考虑的相关指南，但孕期开具抗抑郁药仍然是一个有争议的话题。医生和药剂师在孕期用药问题上可能存在相反观点，对于孕期是否服用治疗抑郁和焦虑症的药物可能会给出相互矛盾的建议。在本研究中，我们调查了全科医生（GP）和药剂师使用的信息来源及其常见做法。
方法
向1400名医疗保健专业人员发送了一份关于信息来源使用情况以及孕期管理抑郁症时的一般方法的问卷，以评估孕期药物安全的信息来源以及影响决策的因素。问卷主要由封闭式多项选择题组成。
结果
共有130名全科医生（19%）和144名药剂师（21%）做出了回应。孕期用药安全性最受欢迎的信息来源是荷兰国家医疗保险系统处方集，而少数受访者会联系荷兰国家致畸学信息服务处（TIS）。大多数全科医生就孕期用药问题向药房咨询。在最佳治疗策略方面，全科医生之间对于治疗方法或共识没有明确的界限，从业者对于首选药物也未达成一致。全科医生对于孕期停用或继续使用抗抑郁药或采用替代治疗方案有不同看法。对于孕期使用抗抑郁药的情况是否需要为母婴提供专科护理，这场争论似乎仍在继续。
结论
初级卫生保健人员对于患有抑郁症的孕妇的治疗意见并不统一。尽管需要更多研究来解决所有安全问题，但地方或国家政策对于避免不良做法（如给出相互矛盾的建议）是必不可少的。全科医生和药剂师应在定期的药物治疗共识会议上讨论这个问题，最好与致畸学信息服务处或该领域的其他专业人员合作。
Zotero 插件