Špoģe Milana, Kursīte Mirdza, Poplavska Elita
Department of Applied Pharmacy, Faculty of Pharmacy, Riga Stradiņš University, LV-1007 Riga, Latvia.
Institute of Public Health, Riga Stradiņš University, LV-1010 Riga, Latvia.
Pharmacy (Basel). 2024 Dec 4;12(6):182. doi: 10.3390/pharmacy12060182.
Valproates are recognized for their significant teratogenic risks, which can lead to physical defects and developmental disorders when used during pregnancy. To mitigate these risks, the Pregnancy Prevention Program (PPP) was developed by European regulators for patients and healthcare professionals (HCPs). Despite the crucial nature of this program, the implementation of the PPP does not appear to be fully effective. This situation highlights the need for a deeper understanding of HCPs' knowledge, attitudes, and behaviors regarding the PPP.
A cross-sectional study using anonymous electronic questionnaires was conducted. The questionnaires were developed by a board of experts from eight different EU countries and were distributed among prescribers (general practitioners (GPs), neurologists, and psychiatrists) and pharmacists. Descriptive statistics were used to analyze the obtained data on participants' knowledge, attitudes, and behaviors regarding the prescribing and dispensing of valproate-containing medicines to women of reproductive age, as well as the impact of PPP materials on their work.
The study results indicate that while HCPs in Latvia are generally aware of valproate teratogenic risks, significant gaps remain in the implementation of the PPP. A considerable number of both prescribers and pharmacists expressed the belief that they are not responsible for educating patients about the PPP, attributing this responsibility to other specialists. Furthermore, barriers such as a lack of time and accessible materials were identified.
The roles and responsibilities of HCPs should be clearly defined to improve adherence to the PPP. Further research is needed to assess prescription and dispensing strategies, as well as HCPs' attitudes toward the PPP. Additionally, re-evaluating and enhancing the accessibility of PPP materials is essential in effective risk management and better patient care.
丙戊酸盐因其显著的致畸风险而被认知，孕期使用时可导致身体缺陷和发育障碍。为降低这些风险，欧洲监管机构为患者和医疗保健专业人员（HCPs）制定了预防妊娠计划（PPP）。尽管该计划至关重要，但PPP的实施似乎并未完全有效。这种情况凸显了深入了解HCPs对PPP的知识、态度和行为的必要性。
采用匿名电子问卷进行横断面研究。问卷由来自八个不同欧盟国家的专家委员会制定，并分发给开处方者（全科医生（GPs）、神经科医生和精神科医生）和药剂师。描述性统计用于分析所获得的关于参与者对育龄妇女开具和调配含丙戊酸药物的知识、态度和行为的数据，以及PPP材料对其工作的影响。
研究结果表明，虽然拉脱维亚的HCPs普遍知晓丙戊酸的致畸风险，但在PPP的实施方面仍存在重大差距。相当数量的开处方者和药剂师都认为他们没有责任向患者宣传PPP，将这一责任归咎于其他专家。此外，还发现了诸如时间不足和材料获取不便等障碍。
应明确界定HCPs的角色和责任，以提高对PPP的依从性。需要进一步研究以评估处方和调配策略，以及HCPs对PPP的态度。此外，重新评估并提高PPP材料的可及性对于有效的风险管理和更好的患者护理至关重要。
