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Reitan Riibe S, Heitmann K, Schjøtt J, Riedel B. Healthcare professionals' information need related to antiseizure medication use in breastfeeding patients with epilepsy. Retrospective analysis of enquiries to Norwegian medicines information and pharmacovigilance centers. Epilepsy Behav Rep 2023; 24:100629. [PMID: 37954010 PMCID: PMC10632412 DOI: 10.1016/j.ebr.2023.100629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/14/2023] Open
Abstract
Background Safety information of antiseizure medication (ASM) during breastfeeding is scarce and conflicting. We aimed to identify characteristic traits of safety concerns among healthcare professionals by reviewing enquiries to the Norwegian Regional Medicines Information and Pharmacovigilance Centres (RELIS). Method Enquiries related to breastfeeding, epilepsy, and ASM identified by their ATC-numbers were retrieved from the RELIS database of question-and-answer pairs (QAPs) by combining indexed and Boolean database searches and manual inspection. 112 QAPs were analyzed retrospectively using descriptive statistics. Results Hospital-employed physicians and nurses were puzzled by ambiguous or conflicting drug information advice and called for general information about the compatibility of an ASM with breastfeeding, mainly related to lamotrigine and levetiracetam. Other enquiries were related to co-medication with other drugs, mainly antidepressants. Half of the enquiries were posed after birth, 12 of these motivated by suspected adverse events in the infants. Conclusion Healthcare professionals with acknowledged high competence in the topic were uncertain about the prevailing safety information of ASM during breastfeeding. The fear to harm the infant may lead to the decision not to recommend breastfeeding. Future information strategies should aim to reach these professions, and support their information need on this topic.
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Affiliation(s)
- Sunniva Reitan Riibe
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Sandnessjøen Helgeland Hospital, Prestmarkveien 1, 8800 Sandnessjøen, Norway
| | - Kristine Heitmann
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, 5021 Bergen, Norway
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, 5021 Bergen, Norway
| | - Jan Schjøtt
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, 5021 Bergen, Norway
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, 5021 Bergen, Norway
| | - Bettina Riedel
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, 5021 Bergen, Norway
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Bakkebø T, Heitmann K, Schjøtt J. Answering questions from breastfeeding women on use of medications: which elements to include, and how to present them? A descriptive pilot study. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2023:7152418. [PMID: 37141392 DOI: 10.1093/ijpp/riad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- Tina Bakkebø
- Department of Medical Biochemistry and Pharmacology, Regional Medicines Information and Pharmacovigilance and Pharmacovigilance Centre (RELIS), Haukeland University Hospital, Bergen, Norway
| | - Kristine Heitmann
- Department of Medical Biochemistry and Pharmacology, Regional Medicines Information and Pharmacovigilance and Pharmacovigilance Centre (RELIS), Haukeland University Hospital, Bergen, Norway
| | - Jan Schjøtt
- Department of Medical Biochemistry and Pharmacology, Regional Medicines Information and Pharmacovigilance and Pharmacovigilance Centre (RELIS), Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
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Information Needs and Counseling Preferences among Potential Users of the Future Teratology Information Service in Belgium: A Cross-Sectional Study Involving the Public and Healthcare Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148605. [PMID: 35886455 PMCID: PMC9319400 DOI: 10.3390/ijerph19148605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023]
Abstract
A Teratology Information Service (TIS) does not exist in Belgium yet but will hopefully be established soon. To prepare for this, we aimed to provide insight into the information needs and counseling preferences of the Belgian public and healthcare professionals (HCPs) regarding medication use in pregnancy and breastfeeding. A cross-sectional study using two anonymous, online surveys disseminated via social media, websites, and newsletters addressing Dutch and French-speaking individuals (≥18 years) and licensed HCPs was performed between June and September 2020. Ethics approval and informed consent were obtained. In total, 1508 public survey respondents (98% women) and 702 HCPs participated. Information needs on perinatal medication use were ubiquitous among both groups, and for which they often relied on patient information leaflets or the product information and online fora. Conflicting information on this topic regularly occurs and complicates HCPs’ duties. Women and HCPs assigned an important role to a TIS, both in terms of providing evidence-based information (via a website or app) and being accessible to be contacted in case of questions (by phone or via e-mail or chat). In conclusion, a TIS would be warmly welcomed by women and HCPs in Belgium and should ideally be established soon to address current information needs regarding perinatal medication use and to contribute to research in this field.
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Smith CA, Hill E, Denejkina A, Thornton C, Dahlen HG. The effectiveness and safety of complementary health approaches to managing postpartum pain: A systematic review and meta-analysis. Integr Med Res 2021; 11:100758. [PMID: 34485073 PMCID: PMC8408636 DOI: 10.1016/j.imr.2021.100758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 12/05/2022] Open
Abstract
Background Women experience pain from a number of causes during the postpartum period. Although pharmacological pain relief has shown to be effective, the efficacy of non-pharmacological methods of pain relief will be of interest to breastfeeding women. The aim of this systematic review was to examine the efficacy and safety of complementary approaches to manage postpartum pain. Methods A search of English language databases from their inception to 2020 was undertaken for randomised controlled trials and included primiparous and multiparous women who experienced postpartum pain up to two weeks post birth. The primary outcome was pain. The risk of bias was assessed using the Cochrane risk of bias tool. Results Thirty trials were included in the review, 25 trials (2,413 women) were included in the meta-analysis. Two trials of massage found a reduction in pain following caesarean birth within the first 24 h post birth (MD -2.64, 95–2.82 to -2.46, 184 women, I2 0%), and at seven days postpartum (MD -1.91, 95%CI -2.42 to -1.40, 2 trials, 120 women I2 37%). Two trials conducted with women receiving an episiotomy found reduction in perineal pain from herbal ointments within 24 h (MD -1.33, 95% CI -.96 to -0.70, 221 women) and at 14 days postpartum (MD -0.74, 95% CI -1.02 to -0.47, 4 trials). Few trials reported on safety, few trials were at an overall low risk of bias, and overall the quality of evidence was very low. Conclusion Further high quality trials are needed to determine the safety and effectiveness of herbal ointment and massage during the early postpartum period.
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Affiliation(s)
- Caroline A Smith
- Graduate Research School, Western Sydney University, Penrith, NSW, Australia.,THRI, Western Sydney University, Penrith, NSW, Australia
| | - Emma Hill
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Anna Denejkina
- Graduate Research School, Western Sydney University, Penrith, NSW, Australia.,THRI, Western Sydney University, Penrith, NSW, Australia.,Young and Resilient Research Centre, Western Sydney University, Penrith, NSW, Australia
| | - Charlene Thornton
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
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Chen LY, Flood-Grady E, Hentschel A, Wright L, Mkuu R, Young A, Francois M, Neu J, Parker LA, Shenkman E, Krieger JL, Lemas DJ. A Qualitative Study of Pregnant Women's Perspectives on Antibiotic Use for Mom and Child: Implications for Developing Tailored Health Education Interventions. Antibiotics (Basel) 2020; 9:antibiotics9100704. [PMID: 33076539 PMCID: PMC7602878 DOI: 10.3390/antibiotics9100704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 11/21/2022] Open
Abstract
The overutilization of antibiotics during pregnancy and early life are associated with adverse health outcomes for mothers and infants. In this study, we explored pregnant women’s opinions and concerns of antibiotics and how perceptions may affect their health-related decision-making. We conducted 18 in-depth, semi-structured interviews with pregnant women and used the Health Belief Model (HBM) as a framework to analyze the data. We found that mothers generally understood the benefits of antibiotics and were aware that antibiotics are clinically effective for treating bacterial infections. Importantly, perceived barriers related to antibiotic use included concerns regarding the impact of antibiotics on breastfeeding efficacy, microbial health, and societal factors such as antimicrobial resistance. The prescription of antibiotics by a healthcare provider was a cue to action for women, as they trusted providers to recommend medications that were safe for them and their infants. Overall, mothers shared that receiving education on the effects of antibiotics would improve their self-efficacy and decision-making surrounding the use of antibiotics for treating illness. Implications for tailored perinatal health education interventions to enhance antibiotic use, knowledge, and decision-making are discussed.
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Affiliation(s)
- Lynn Y. Chen
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (L.Y.C.); (A.H.); (L.W.); (R.M.); (A.Y.); (M.F.); (E.S.)
| | - Elizabeth Flood-Grady
- STEM Translational Communication Center, College of Journalism and Communications, University of Florida, Gainesville, FL 32611, USA; (E.F.-G.); (J.L.K.)
- Clinical Translational Science Institute, University of Florida, Gainesville, FL 32611, USA
| | - Austen Hentschel
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (L.Y.C.); (A.H.); (L.W.); (R.M.); (A.Y.); (M.F.); (E.S.)
| | - Lauren Wright
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (L.Y.C.); (A.H.); (L.W.); (R.M.); (A.Y.); (M.F.); (E.S.)
| | - Rahma Mkuu
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (L.Y.C.); (A.H.); (L.W.); (R.M.); (A.Y.); (M.F.); (E.S.)
- Clinical Translational Science Institute, University of Florida, Gainesville, FL 32611, USA
| | - Alyson Young
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (L.Y.C.); (A.H.); (L.W.); (R.M.); (A.Y.); (M.F.); (E.S.)
| | - Magda Francois
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (L.Y.C.); (A.H.); (L.W.); (R.M.); (A.Y.); (M.F.); (E.S.)
- Clinical Translational Science Institute, University of Florida, Gainesville, FL 32611, USA
| | - Josef Neu
- Department of Pediatrics, University of Florida Health, Gainesville, FL 32611, USA;
| | - Leslie A. Parker
- Department of Behavioral Nursing Science, University of Florida, Gainesville, FL 32611, USA;
| | - Elizabeth Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (L.Y.C.); (A.H.); (L.W.); (R.M.); (A.Y.); (M.F.); (E.S.)
- Clinical Translational Science Institute, University of Florida, Gainesville, FL 32611, USA
| | - Janice L. Krieger
- STEM Translational Communication Center, College of Journalism and Communications, University of Florida, Gainesville, FL 32611, USA; (E.F.-G.); (J.L.K.)
- Clinical Translational Science Institute, University of Florida, Gainesville, FL 32611, USA
| | - Dominick J. Lemas
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL 32611, USA; (L.Y.C.); (A.H.); (L.W.); (R.M.); (A.Y.); (M.F.); (E.S.)
- Clinical Translational Science Institute, University of Florida, Gainesville, FL 32611, USA
- Correspondence: ; Tel.: +352-294-5971
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