School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Mothersafe, The Royal Hospital for Women, Sydney, New South Wales, Australia.
PLoS One. 2022 Oct 6;17(10):e0270940. doi: 10.1371/journal.pone.0270940. eCollection 2022.
MotherSafe is a free telephone-based counseling service for Australian consumers and health-care providers concerned about drug exposures during pregnancy and breastfeeding. Anti-infectives are the most commonly prescribed drugs for pregnant women. This study aims to provide a descriptive analysis of prospectively collected calls received by MotherSafe regarding anti-infective exposures during pregnancy between 2000 and 2020. Aggregate data were examined by type of caller, reason for call, pregnancy category and exposure type. Inductive thematic analysis of the comments recorded by MotherSafe counsellors at the time of call was undertaken.
Over the study period, 25,890 calls related to exposure to anti-infectives during pregnancy (antibiotic, antiviral, and antifungal medications). Calls from patients were dominated by low-risk exposures (pregnancy category A) to drugs while calls from health care professionals related to drugs with limited human information (pregnancy category B3). Analysis of MotherSafe counsellor comments revealed over 200 instances of concerns relating to health care professional advice to the patient. Three themes emerged: incorrect or conflicting advice, poor counselling, and refusal to treat, prescribe or dispense. It is likely that these comments are biased to the negative as patients would not call MotherSafe if they were happy with HCP advice. However, the findings are concerning as they reveal an underlying lack of knowledge in some health care professionals which may have led to undertreatment of patients. This study reinforced the importance of Teratogen Information Services such as MotherSafe in providing counselling and clear communication of evidence-based information to guide decision-making, reducing potential emotional distress in pregnant women, and optimizing maternal, pregnancy and infant outcomes.
MotherSafe 是一个免费的电话咨询服务，面向澳大利亚的消费者和医疗保健提供者，关注孕妇和哺乳期妇女的药物暴露问题。抗感染药物是孕妇最常开的药物。本研究旨在对 MotherSafe 在 2000 年至 2020 年期间收到的关于孕妇抗感染药物暴露的前瞻性电话咨询进行描述性分析。按来电者类型、来电原因、妊娠类别和暴露类型对汇总数据进行了检查。对 MotherSafe 顾问在来电时记录的评论进行了归纳主题分析。
在研究期间，共有 25890 个与怀孕期间抗感染药物暴露（抗生素、抗病毒和抗真菌药物）相关的电话。来自患者的电话主要是低风险暴露（妊娠 A 类）到药物，而来自医疗保健专业人员的电话则与人类信息有限的药物（妊娠 B3 类）有关。对 MotherSafe 顾问评论的分析显示，有 200 多例与医疗保健专业人员向患者提供的建议有关的担忧。出现了三个主题：错误或相互矛盾的建议、不良咨询和拒绝治疗、开处方或配药。这些评论很可能带有负面偏见，因为如果患者对 HCP 的建议满意，他们就不会打电话给 MotherSafe。然而，这些发现令人担忧，因为它们揭示了一些医疗保健专业人员潜在的知识缺乏，这可能导致对患者的治疗不足。这项研究强调了 MotherSafe 等致畸信息服务的重要性，它为咨询和清晰沟通基于证据的信息提供了指导，以做出决策，减轻孕妇的潜在情绪困扰，并优化母婴和婴儿的结局。
