Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
Division of Social and Administrative Pharmacy, School of Pharmacy, Faculty of Health Sciences, Jimma Institute of Health, Jimma University, Jimma, Ethiopia.
BMC Pregnancy Childbirth. 2020 Nov 26;20(1):737. doi: 10.1186/s12884-020-03433-6.
Studies on medication-related problems (MRPs) among pregnant women are scarce, despite the potential consequences for both mother and child. This study aimed to describe the prevalence, clinical significance, and risk factors for MRPs among hospitalized pregnant or postpartum women at Jimma University Medical Centre (JUMC) in Ethiopia.
A prospective follow-up and clinical audit of 1117 hospitalized pregnant or postpartum women in the maternity and gynaecology wards at JUMC was carried out between February and June 2017. Patients were followed throughout their stay in the hospital to assess the presence and development of MRPs. Pre-tested data extraction form and an interview-guided structured questionnaire were used to collect data. Descriptive statistics were used to describe MRPs. Logistic regression analysis was used to identify factors associated with MRPs.
One or more MRPs occurred among 323 (28.9%) study participants, mostly in relation to lack of iron supplementation. A total of 278 (70.6%) of all MRPs were considered to be of moderate to high clinical significance. When excluding MRPs due to iron from the analysis, chronic disease (adjusted OR 1.91; 95% CI 1.02, 3.58), medication use prior to admission (adjusted OR 2.38; 95% CI 1.24, 4.56), nulliparity (adjusted OR 1.99; 95% CI 1.22, 3.24) and multiparity (adjusted OR 1.91; 95% CI 1.17, 3.12) were significantly associated with experiencing an MRP.
Nearly 3 out of 10 hospitalized pregnant women at JUMC had one or more MRPs. The need for additional iron therapy was by far the most common type of MRP. Improved adherence to guidelines on iron supplementation are required. Multidisciplinary approaches including physicians, nurses, anesthesia professionals and clinical pharmacists in the maternity and gynaecology wards could possibly prevent MRPs and promote patient safety for women and children.
尽管孕妇用药相关问题（MRPs）可能会对母婴双方都产生潜在影响，但针对孕妇的此类研究仍十分匮乏。本研究旨在描述在埃塞俄比亚 Jimma 大学医学中心（JUMC）住院的孕妇或产后女性中，MRPs 的流行程度、临床意义和危险因素。
2017 年 2 月至 6 月，对 JUMC 妇产科病房的 1117 名住院孕妇或产后女性进行了前瞻性随访和临床审核。对患者在住院期间进行了随访，以评估 MRPs 的存在和发展情况。使用经过预测试的数据提取表和访谈引导的结构化问卷收集数据。采用描述性统计方法描述 MRPs。采用 logistic 回归分析确定与 MRPs 相关的因素。
在 323 名（28.9%）研究参与者中，1 人或多人出现了 1 种或多种 MRPs，其中大部分与缺乏铁补充有关。所有 MRPs 中，共有 278 种（70.6%）被认为具有中高度的临床意义。在排除因铁引起的 MRPs 后，慢性病（调整后的 OR=1.91；95%CI=1.02，3.58）、入院前用药（调整后的 OR=2.38；95%CI=1.24，4.56）、初产妇（调整后的 OR=1.99；95%CI=1.22，3.24）和多产妇（调整后的 OR=1.91；95%CI=1.17，3.12）与发生 MRPs 显著相关。
JUMC 近 3 成住院孕妇出现 1 种或多种 MRPs。需要额外铁治疗是最常见的 MRPs 类型。需要提高对铁补充指南的遵循度。妇产科病房中的医生、护士、麻醉师和临床药师等多学科方法，有可能预防 MRPs 并为母婴安全提供保障。
