Department of Pharmacy, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
Department of Pharmacy, South Texas Veterans Health Care System, Audie L. Murphy Veterans Hospital, San Antonio, TX.
Am J Health Syst Pharm. 2020 Aug 20;77(Suppl 3):S71-S77. doi: 10.1093/ajhp/zxaa159.
To assess the rate at which contraceptive counseling is provided to women of childbearing age prescribed teratogenic medications at Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC). Women of childbearing age comprise a large demographic of women veterans and may require contraceptive counseling in the event a potentially teratogenic medication is prescribed. According to multiple studies, overall documentation of contraceptive counseling occurs in approximately half of this population or less. The rate of documented contraceptive counseling at MEDVAMC is unknown.
A retrospective chart review of electronic health records was conducted from January 2017 to August 2018. Patients included were female veterans between 18 and 45 years of age who made 2 or more visits to MEDVAMC prior to filling a prescription for a HMG-CoA reductase inhibitor (statin), angiotensin-converting enzyme inhibitor, or angiotensin II receptor blocker. Charts were screened for documentation of contraceptive counseling (including family planning counseling), prescribed contraception, and pregnancy testing prior to dispensing of a potentially teratogenic prescription.
There were 172 female veterans included in this project. Documentation of contraceptive counseling occurred in 63% (n = 108) of patients; in total, 42% (n = 73) of patients were on some form of contraception, with the most common being oral contraceptive pill (used by 30% of women).
The rate of documentation of contraceptive counseling at MEDVAMC was found to be higher than rates reported in national studies. As we continue to strive to provide exceptional care for our women veterans, we would like to continue to increase the education and awareness on this matter.
评估在迈克尔·E·德贝基退伍军人事务医疗中心（MEDVAMC）为开致畸药物处方的育龄妇女提供避孕咨询的比率。育龄妇女是女退伍军人中的一个重要群体，如果开了可能致畸的药物，她们可能需要避孕咨询。根据多项研究，在这一人群中，大约有一半或更少的人有避孕咨询记录。MEDVAMC 记录避孕咨询的比率尚不清楚。
对 2017 年 1 月至 2018 年 8 月的电子健康记录进行了回顾性图表审查。纳入的患者为 18 至 45 岁之间的女性退伍军人，她们在开 HMG-CoA 还原酶抑制剂（他汀类药物）、血管紧张素转换酶抑制剂或血管紧张素 II 受体阻滞剂处方前在 MEDVAMC 就诊 2 次或以上。筛选图表以记录避孕咨询（包括计划生育咨询）、开处方的避孕措施和在开出致畸处方前的妊娠检测。
该项目共纳入 172 名女性退伍军人。63%（n=108）的患者有避孕咨询记录；总共有 42%（n=73）的患者使用某种形式的避孕措施，最常见的是口服避孕药（30%的女性使用）。
在 MEDVAMC 记录避孕咨询的比率高于全国研究报告的比率。在我们继续努力为我们的女性退伍军人提供卓越的护理的同时，我们希望继续提高对这一问题的教育和认识。
