Kirubarajan Abirami, Lam Andrew, Yu Amy, Taheri Cameron, Khan Shawn, Sethuram Claire, Mehta Vikita, Olivieri Nancy
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
J Family Reprod Health. 2021 Sep;15(3):160-171. doi: 10.18502/jfrh.v15i3.7133.
The objective of our study is to characterize the knowledge, information sources, and institutional trust of patients regarding medication use in pregnancy. We conducted a review of three databases: MEDLINE, EMBASE, and CINAHL. We included observational studies and knowledge assessments that examined the knowledge, attitudes, beliefs or information sources of pregnant patients related to medication use during pregnancy. Extraction was completed by two independent reviewers, outcomes were summarized descriptively, and appraisal was conducted. Of the 1359 search results, 34 studies met inclusion criteria. Thus, our systematic review encompasses the beliefs of 11,757 pregnant participants. In most studies, participants described apprehension regarding potential risks to the fetus and the inadequacy of safety information. Across the 23 knowledge assessments, the majority of studies reported patient misconceptions about prescription medication in pregnancy. The most preferred information source was a healthcare provider. However, many participants expressed frustration, mistrust, and skepticism regarding physician knowledge. A common source of mistrust was due to perceived physician self-interest as well as a lack of education tailored to pregnancy. Consequently, informal sources of information were also popular. There is a need to improve the health literacy and trust among pregnant patients regarding drug prescribing. There are modifiable risk factors for mistrust that require further attention.
我们研究的目的是描述患者在孕期用药方面的知识、信息来源以及对医疗机构的信任情况。我们对三个数据库进行了检索：医学文献数据库（MEDLINE）、荷兰医学文摘数据库（EMBASE）和护理学与健康领域数据库（CINAHL）。我们纳入了观察性研究和知识评估，这些研究考察了孕妇在孕期用药方面的知识、态度、信念或信息来源。由两名独立的评审人员完成数据提取，对结果进行描述性总结，并进行评估。在1359条检索结果中，有34项研究符合纳入标准。因此，我们的系统评价涵盖了11757名孕妇参与者的信念。在大多数研究中，参与者描述了对胎儿潜在风险的担忧以及安全信息的不足。在23项知识评估中，大多数研究报告了患者对孕期处方药的误解。最受欢迎的信息来源是医疗保健提供者。然而，许多参与者对医生的知识表示沮丧、不信任和怀疑。不信任的一个常见原因是认为医生存在自身利益，以及缺乏针对孕期的教育。因此，非正式信息来源也很受欢迎。有必要提高孕妇在药物处方方面的健康素养和信任度。存在一些可改变的导致不信任的风险因素，需要进一步关注。
