Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway.
Curr Pharm Des. 2019;25(5):469-482. doi: 10.2174/1381612825666190321110420.
During pregnancy, women might weigh the benefits of treatment against potential risks to the unborn child. However, non-adherence to necessary treatment can adversely affect both mother and child. To optimize pregnant women's beliefs and medication adherence, community pharmacists are ideally positioned to play an important role in primary care.
This narrative review aimed to summarize the evidence on 1) pregnant women's beliefs, 2) medication adherence in pregnancy and 3) community pharmacists' counselling during pregnancy.
Three search strategies were used in Medline and Embase to find original studies evaluating women's beliefs, medication adherence and community pharmacists' counselling during pregnancy. All original descriptive and analytic epidemiological studies performed in Europe, North America and Australia, written in English and published from 2000 onwards were included.
We included 14 studies reporting on women's beliefs, 11 studies on medication adherence and 9 on community pharmacists' counselling during pregnancy. Women are more reluctant to use medicines during pregnancy and tend to overestimate the teratogenic risk of medicines. The risk perception varies with the type of medicine, level of health literacy, education level and occupation. Furthermore, low medication adherence during pregnancy is common. Finally, limited evidence showed that the current community pharmacists' counselling is insufficient. Barriers hindering pharmacists are insufficient knowledge and limited access to reliable information.
Concerns about medication use and non-adherence are widespread among pregnant women. Community pharmacists' counselling during pregnancy is insufficient. Further education, training and research are required to support community pharmacists in fulfilling all the opportunities they have when counselling pregnant women.
在妊娠期间，女性可能会权衡治疗的益处与对胎儿的潜在风险。然而，不遵守必要的治疗可能会对母婴双方产生不利影响。为了优化孕妇的信念和药物依从性，社区药剂师在初级保健中处于理想的地位，可以发挥重要作用。
本叙述性综述旨在总结以下方面的证据：1）孕妇的信念，2）妊娠期间的药物依从性，以及 3）社区药剂师在妊娠期间的咨询。
在 Medline 和 Embase 中使用了三种搜索策略，以查找评估孕妇信念、药物依从性和社区药剂师在妊娠期间咨询的原始研究。纳入了所有在欧洲、北美和澳大利亚进行的、评估孕妇信念、药物依从性和社区药剂师在妊娠期间咨询的原始描述性和分析性流行病学研究，这些研究为英文且发表于 2000 年以后。
我们纳入了 14 项关于女性信念的研究、11 项关于药物依从性的研究和 9 项关于社区药剂师在妊娠期间咨询的研究。孕妇在妊娠期间更不愿意使用药物，并且往往高估药物的致畸风险。风险认知因药物类型、健康素养水平、教育程度和职业而异。此外，妊娠期间药物依从性低很常见。最后，有限的证据表明，目前社区药剂师的咨询是不够的。阻碍药剂师的因素是知识不足和获取可靠信息的途径有限。
孕妇对药物使用和不依从的担忧普遍存在。妊娠期间社区药剂师的咨询不足。需要进一步的教育、培训和研究，以支持社区药剂师在为孕妇提供咨询时充分利用他们所有的机会。
