Charlton R A, Bettoli V, Bos H J, Engeland A, Garne E, Gini R, Hansen A V, de Jong-van den Berg L T W, Jordan S, Klungsøyr K, Neville A J, Pierini A, Puccini A, Sinclair M, Thayer D, Dolk H
Department of Pharmacy and Pharmacology, University of Bath, Bath, BA2 7AY, UK.
Department of Clinical and Experimental Medicine, Section of Dermatology, University of Ferrara, Ferrara, Italy.
Eur J Clin Pharmacol. 2018 Apr;74(4):513-520. doi: 10.1007/s00228-017-2398-9. Epub 2017 Dec 11.
Pregnancy prevention programmes (PPPs) exist for some medicines known to be highly teratogenic. It is increasingly recognised that the impact of these risk minimisation measures requires periodic evaluation. This study aimed to assess the extent to which some of the data needed to monitor the effectiveness of PPPs may be present in European healthcare databases.
An inventory was completed for databases contributing to EUROmediCAT capturing pregnancy and prescription data in Denmark, Norway, the Netherlands, Italy (Tuscany/Emilia Romagna), Wales and the rest of the UK, to determine the extent of data collected that could be used to evaluate the impact of PPPs.
Data availability varied between databases. All databases could be used to identify the frequency and duration of prescriptions to women of childbearing age from primary care, but there were specific issues with availability of data from secondary care and private care. To estimate the frequency of exposed pregnancies, all databases could be linked to pregnancy data, but the accuracy of timing of the start of pregnancy was variable, and data on pregnancies ending in induced abortions were often not available. Data availability on contraception to estimate compliance with contraception requirements was variable and no data were available on pregnancy tests.
Current electronic healthcare databases do not contain all the data necessary to fully monitor the effectiveness of PPP implementation, and thus, special data collection measures need to be instituted.
针对某些已知具有高度致畸性的药物,已制定了预防妊娠计划(PPP)。人们越来越认识到,这些风险最小化措施的影响需要定期评估。本研究旨在评估欧洲医疗保健数据库中可能存在的、用于监测PPP有效性的部分数据的情况。
完成了一份关于为EUROmediCAT提供数据的数据库的清单,这些数据库收集了丹麦、挪威、荷兰、意大利(托斯卡纳/艾米利亚-罗马涅)、威尔士和英国其他地区的妊娠和处方数据,以确定所收集的数据可用于评估PPP影响的程度。
不同数据库的数据可用性各不相同。所有数据库都可用于确定育龄妇女在初级保健中的处方频率和持续时间,但二级保健和私人保健的数据可用性存在特定问题。为了估计暴露妊娠的频率,所有数据库都可与妊娠数据相链接,但妊娠开始时间的准确性各不相同,而且关于人工流产终止妊娠的数据往往无法获取。用于估计避孕措施依从性的避孕数据可用性各不相同,且没有关于妊娠试验的数据。
当前的电子医疗保健数据库并不包含全面监测PPP实施有效性所需的所有数据,因此,需要采取特殊的数据收集措施。