School of Pharmacy, University of Otago, Dunedin, 9010, New Zealand.
Arch Womens Ment Health. 2021 Aug;24(4):569-578. doi: 10.1007/s00737-021-01118-3. Epub 2021 Mar 9.
Women face complicated decisions regarding psychotropic medication use during pregnancy. Patient decision aids (PDAs) could be a valuable tool to assist with decision-making. The objective of this review was to evaluate the effectiveness of PDAs in this population. A systematic search of the literature was conducted using PRISMA guidelines. Three major databases were searched to identify articles published between 2006 and June 2020. Studies were included if they evaluated use of a PDA for women considering medication for mental illness during pregnancy. A total of 4629 titles were returned from the search; however, only three studies met inclusion criteria and were selected for analysis. Two were pilot randomised controlled trials in women considering antidepressant use during pregnancy, and one was a non-randomised study in women considering medication for the treatment of opioid use disorder (OUD). The PDAs had good acceptability across all three studies. The randomised trials assessed knowledge, decisional conflict, depression, and anxiety, with non-significant trends towards reduced decisional conflict and anxiety in the PDA groups. PDAs have the potential to assist women with mental illnesses to make decisions regarding medication use during pregnancy; however, current evidence is too limited to evaluate the effectiveness of PDAs for this population.
女性在怀孕期间使用精神药物时面临复杂的决策。患者决策辅助工具（PDA）可能是辅助决策的有价值的工具。本综述的目的是评估 PDAs 在该人群中的有效性。按照 PRISMA 指南进行了系统的文献检索。使用三个主要数据库搜索了 2006 年至 2020 年 6 月期间发表的文章。如果研究评估了在考虑怀孕期间使用精神药物治疗精神疾病的女性使用 PDA 的情况，则将其纳入研究。从检索中返回了 4629 个标题；但是，只有三项研究符合纳入标准并被选中进行分析。其中两项是针对考虑在怀孕期间使用抗抑郁药的女性的试点随机对照试验，另一项是针对考虑药物治疗阿片类药物使用障碍（OUD）的女性的非随机研究。所有三项研究均显示 PDA 的接受度良好。随机试验评估了知识、决策冲突、抑郁和焦虑，PDA 组的决策冲突和焦虑呈非显著下降趋势。PDA 有可能帮助患有精神疾病的女性做出关于怀孕期间药物使用的决策；但是，目前的证据还太有限，无法评估 PDA 对该人群的有效性。
