Sawicki Emilia, Stewart Kay, Wong Swee, Leung Laura, Paul Eldho, George Johnson
Centre for Medicine Use and Safety, Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, and Pharmacy Department, The Royal Women's Hospital, Parkville, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2011 Aug;51(4):333-8. doi: 10.1111/j.1479-828X.2011.01312.x. Epub 2011 Apr 18.
Most women use medications at some stage in their pregnancy. Medication nonadherence during pregnancy could be detrimental to both mother and fetus.
To study the extent and nature of the use of prescribed medications during pregnancy and factors associated with medication nonadherence.
All women≥18 years presenting for their 36th week antenatal visit at the pregnancy clinic of a maternity hospital were invited to complete an anonymous questionnaire that contained 61 items, including the Morisky scale. Factors associated with nonadherence were identified in univariate analysis; factors with P<0.1 were further analysed in a binary logistic regression model.
The participants (n=819) had a mean age of 30.8±5.3 years. Most participants were born in Australia, lived with a partner, had university education, were nulliparous, carried one fetus and were nonsmokers. Of these participants, 322 (39.3%) reported a chronic health condition during pregnancy, the most common being asthma (104; 12.7%). Two hundred and seventeen (26.5%) were using prescribed medications, which included anti-anaemics (68; 8.3%), medicines for chronic airway conditions (64; 7.8%), vitamins and minerals (59; 7.2%) and anti-diabetics (43; 5.2%). Nonadherence was reported by 107 (59.1%) participants, mainly because of forgetting (79; 43.6%). Factors associated with nonadherence were having asthma (OR 0.26 (95% CI 0.095-0.72), P=0.009) and using nonprescription dietary minerals (0.30 (0.10-0.87), P=0.027).
Adherence to prescribed medicines during pregnancy is alarmingly low. Health professionals should be more proactive in promoting adherence and assisting women avoid potential fetal harm because of nonadherence.
大多数女性在孕期的某个阶段会使用药物。孕期不坚持用药可能对母亲和胎儿都有害。
研究孕期使用处方药的程度和性质以及与不坚持用药相关的因素。
邀请所有在一家妇产医院的孕期诊所进行第36周产前检查的18岁及以上女性填写一份包含61个项目的匿名问卷，其中包括莫利斯基量表。在单因素分析中确定与不坚持用药相关的因素；P<0.1的因素在二元逻辑回归模型中进一步分析。
参与者（n = 819）的平均年龄为30.8±5.3岁。大多数参与者出生在澳大利亚，与伴侣同住，接受过大学教育，未生育过，怀有单胎且不吸烟。在这些参与者中，322人（39.3%）报告在孕期患有慢性健康问题，最常见的是哮喘（104人；12.7%）。217人（26.5%）正在使用处方药，其中包括抗贫血药（68人；8.3%）、治疗慢性气道疾病的药物（64人；7.8%）、维生素和矿物质（59人；7.2%）以及抗糖尿病药（43人；5.2%）。107名（59.1%）参与者报告有不坚持用药的情况，主要原因是忘记（79人；43.6%）。与不坚持用药相关的因素是患有哮喘（比值比0.26（95%置信区间0.095 - 0.72），P = 0.009）和使用非处方膳食矿物质（0.30（0.10 - 0.87），P = 0.027）。
孕期对处方药的依从性低得惊人。卫生专业人员应更积极地促进依从性，并帮助女性避免因不坚持用药而对胎儿造成潜在伤害。
